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[ What are sinuses? ] [ What is sinusitis? ] [ How is sinusitis diiagnosed? ] [ How is sinusitis treated? ] [ Functional Endoscopic Sinus Surgery ]

What is sinusitis and what causes it?

What is sinusitis?

Sinusitis is defined as inflammation of the sinuses. The sinuses are chambers that communicate with the nasal cavity through tiny openings (See "What are sinuses?"). They become inflamed due to a variety of causes but typical sinusitis is due to a bacterial infection. Often the problem in the sinuses occurs in association with a condition that affects the nasal cavity, such as allergies, a viral infection, or irritation. Because the nasal cavity and the sinuses typically react in conjunction with one another, some experts have suggested that the term "sinusitis" be replaced with "rhinosinusitis" (rhino = nose) to emphasize this association.

Sinusitis is a common condition that affects millions of people across the world. It has been estimated that as many as 35 million Americans suffer from this disease at that it accounts for at least $2.4 billion in direct medical costs alone. This figure does not take into account the economic impact of lost productivity, work days lost for illness, and time lost for doctor's office visits.

What causes sinusitis?

As mentioned earlier, sinusitis typically occurs in association with conditions that affect the nasal cavity, such as allergies, irritations to the nose, or a viral infection (like a common cold). All of these conditions cause the lining of the nose (the "mucosa") to swell. This swelling, often called "edema," further constricts the already narrow openings through which mucus leaves the sinus. Air circulation into and out of the sinuses is also impaired. With further inflammation, the movement of mucus out of the sinuses by the microscopic hairs called cilia slows and the secretions become stagnant. These conditions favor growth of bacteria and an infection sets in. Once the bacterial infection begins, it causes more inflammation and swelling and leading to increased mucus production. More swelling only worsens the mucus transport and air exchange, favoring more bacterial growth and the cycle continues.

Symptoms of sinusitis can be quite variable, both in whether or not they are present and how severe they are. They can mimic many other conditions, including the common cold, allergies, migraines and other types of headaches, and jaw problems. Patients with sinusitis typically have at least one of the following symptoms:

• discolored nasal discharge - often yellow or green

• facial fullness, heaviness, or congestion

• facial pain or pressure

• decrease or loss of the sense of smell (the sense of taste may also be affected)

• decrease in the ability to breathe through the nose

Other symptoms that patients may have in association with the ones above are:

• fever - often low grade and variable

• fatigue or malaise (flu-like symptoms)

• pain in the upper teeth

• pressure or fullness in the ears

• chronic cough

• bad breath

Clearly, these symptoms are not specific and could be from a number of conditions. It is for this reason that sinusitis can be difficult to diagnose. Fortunately, recent diagnostic advances have improved our ability to accurately identify patients with sinusitis so that they can be appropriately treated.

Go to next page: "How is sinusitis diagnosed?"