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We can easily say that sinusitis is one of the most common health problems, since every year almost 37 million people in the United States have sinusitis attack. This number might significantly increase because some people easily mistaken this illness with cold and allergic flu.

What is sinusitis?
Acute bacterial sinusitis is a microbial infection of the sinuses and the mucosa covering sinusal cavities. This condition usually arises as a result of cold, allergy episodes or environmental pollution. The diagnosis is established by an ENT expert and its therapy is initiated. This is essential to avoid possible complications that might arise in the future. Normally, the accumulated mucus secretion in the sinus cavities flows into the nasal cavity. However, during the allergy attack or cold, mucosal coating of the sinuses becomes congested so the mucus cannot be  drained  into the nasal cavity. Mucus secretion accumulates in the sinuses and get infected by germs. This is called sinusitis. Mostly depending on the clinical complaints, the diagnosis is made by an ENT expert following a detailed physical examination. Sometimes the physician may need to order X-ay graphy or take a sample from nasal discharge.

When does acute sinusitis transform to chronic sinusitis?
If there are episodes that last for over 3 months and have frequent recurrences, this can be defined as chronic sinusitis. In chronic sinusitis, symptoms are relatively milder than the acute one, but in the untreated cases damage in sinuses or bony structures might occur.

How is sinusitis treated?
Antibiotic Treatment: Bacterial Sinusitis treatment must definitely include a proper antibiotic. If you have 3 or more symptoms (see table below),  most probably, you have sinusitis and you have to see an ENT specialist. Oral tablets or nasal spray decongestants and mucolytic mucus thinners with anti-inflammatory medications may be added to the therapy if needed. It is of primary importance that the decongestant nasal drops should not be used for much longer than the recommended period of time. Salty water or ocean water sprays can be used for intranasal irrigation. Antibiotic drug resistance is a significant challenge. When an antibiotic loses its capability to effectively control and cease bacterial growth, this means that the bacteria survive and continue to multiply due to its acquired immunity against drugs. Antibiotic drugs that obtained OTC from pharmacies, should never be used without prescription and must be taken during recommended duration as ordered.

Sinus Surgery: If no effectual results are obtained from drug treatments and there is obstruction in the nasal cavity or in sinusal gapes with no help of medications at all, then surgical intervention is preferred. However, there are many ways to reach the sinuses in surgical treatment, the functional endoscopic sinus surgery is the most resorted interventional method today. Within the method, operation is performed by directly viewing the intranasal cavity by means of endoscopic devices. Afflicted tissue inside nose such as polyps are removed and narrow conduits are opened. Navigation surgery, balloon sinuplasty or Caldwell-Luc operation are other options in sinus surgery. In the relevant chapter, these interventions have been explained in detail. In sinusitis therapy, there must be a close collaboration between the patient and the doctor. The sinusitis therapy will not end just after operation. Obligatory principles before and after surgery are explained to the patient and the patient is supposed to obey the instruction as well. A perfect result can then be accomplished. An allergic ground, weakness in immune system, passive smoking, gastro-esophageal reflux must be investigated and corrected for recurrent and refractory cases in childhood. Adenoid vegetation resection is preferred and is really helpful in the majority of cases suffering from recurrent attacks and refractory to medical therapy.


Do I have sinusitis?

Sings and Findings Sinusitis Allergy Cold
Duration of disease longer than 10-14 days variable shorter than 10 days
Nasal Secretion white-like yellow greenish clear watery aqueous whitish dense or liquified
Feber occasionally No occasionally
Headache occasionally occasionally occasionally
Upper Dental Pain occasionally No No
Bad Breath occasionally No No
Cough occasionally occasionally No
Nasal Congestion Yes occasionally Yes
Sneeze No occasionally Yes

* If you are suffering from 3 or more symptoms in the table above, very likely, you have sinusitis and you should consult an ENT specialist.


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