What is sinusitis?

Everyone has sinuses. They are small spaces inside the skull through which air passes. You will find them under the bone forming the forehead, round and behind the eyes, under the cheeks and around the nose. Under normal circumstances, they are free from infection. Indeed, the majority of these spaces are lined with a mucus membrane and hairs called cilia that keep the areas sterile by draining all foreign matter and allowing the air to pass. But if the passages should become blocked or the cilia stop working properly, the mucus builds up and an infection can result. Alternatively, the body may produce too much mucus because of a different disorder such as a respiratory infection or an allergic reaction, and this excess causes the sinuses to become blocked.

Under normal circumstances, the inflammation only lasts a few days or weeks. In other words, it comes on after you have caught a cold and then goes away again. However, some conditions are chronic and last months and, occasionally, years. The possible causes of inflammation are a virus, a fungus or a bacterium. Only susceptible bacteria can be killed by using an antibiotic like Azithromycin so, to ensure you get effective treatment and relief from the discomfort and pain, you need a physician to make a diagnosis and identify the cause.

You are more likely to have problems with sinusitis if you live or work in an environment affected by smoke or other pollutants. This can affect the lining of your sinus and lead to a build up of mucus. The same can happen if you overuse nasal decongestants. Although there is a temptation to use these products when your nose is blocked, they can actually slow down the action of the cilia and lead to more serious blockages. The same is true for those who swim or go scuba diving. Changes in pressure can affect the way in which the sinuses work. People who suffer from allergies and asthma are also prone to sinus problems. Finally and only in this one limited situation, chronic sinusitis can be the first symptom of the onset of cystic fibrosis.

If the symptoms persist for more than one week with pain behind the eyes, toothache, reduction in the ability to smell and a fever, this is more likely to require detailed testing to identify the cause. You cannot assume that because the symptoms are persistent, this must be a bacterium and so turn to Azithromycin. At the very least, you should have lab work done to test swabs from your nose. Blood tests to test whether your immune system is working properly and tests to determine whether you have allergies are also good ideas. Physical examination by shining a bright light on to the skin is not very effective to identify whether there is a blockage. You may have to consider a CT scan or MRI to identify possible fungal infections or a tumor.

The standard forms of treatment begin with the application of heat to the face, inhaling steam or using a humidifier, and drinking plenty of fluids. If these do not work, you will need a physician to advise on whether to use Azithromycin, one of the virus or fungal specific medications, or a nasal corticosteroid spray. In the worst cases, surgery may be required to clean and drain the sinuses, remove any polyps or other physical blockages, and repair sites where fungal infections have been located.