February 2025, article by Dr. Guido Coen Tirelli, otorhinolaryngologist at Aventino Medical Group.
The nasal and paranasal sinuses play a crucial role in respiratory health, but they often become sites of infections that can cause significant discomfort. Among these, sinusitis is one of the most common conditions, often underestimated but capable of significantly affecting quality of life. In this article, we will explore in detail what sinusitis is, its symptoms, causes, risk factors, and how to prevent and treat it.
What Are the Nasal and Paranasal Sinuses?
The nasal and paranasal sinuses are air-filled cavities located within the bones of the skull and face. They are lined with a thin mucous membrane and connect to the nasal cavities through small channels. The main paranasal sinuses are:
- Frontal sinuses: above the eyebrows.
- Maxillary sinuses: in the cheeks, below the eyes.
- Ethmoid sinuses: between the eyes, near the nose.
- Sphenoid sinuses: deeper, behind the eyes.
These cavities function to warm and humidify the air, lighten the skull, produce mucus to filter dust and pathogens, and amplify the voice.
Sinusitis Symptoms: How to Recognize It?
Sinusitis can present with a variety of symptoms, which often depend on the duration and severity of the inflammation. The most common symptoms of sinusitis include:
- Nasal congestion: a feeling of nasal blockage that makes breathing difficult.
- Nasal discharge: thick mucus, often yellow or green, that may drain from the nose or down the throat (postnasal drip).
- Facial pain or pressure: localized around the eyes, cheeks, forehead, or upper teeth.
- Persistent headache: often caused by pressure in the inflamed sinuses.
- Reduced or lost sense of smell: due to mucosal inflammation.
- Foul odors perceived only by the patient (cacosmia).
- Fever: more common in bacterial sinusitis.
- Fatigue: related to the body fighting the infection.
- Bad breath (halitosis): often associated with stagnant mucus.
- Earache or ear pressure: a frequent symptom if the inflammation spreads.
These symptoms may last a few days (acute sinusitis) or persist for weeks or months (chronic sinusitis). If you recognize these signs, it is important to consult a doctor for an accurate diagnosis.
How Does Sinusitis Develop?
Sinusitis occurs when the paranasal sinuses become inflamed or infected. The main causes include:
- Viral infections: such as the common cold, which can block drainage channels.
- Bacterial infections: cause more severe and persistent symptoms.
- Allergies: allergic rhinitis that inflames the nasal mucosa.
- Anatomical factors: such as a deviated nasal septum or polyps that obstruct normal drainage.
- Gastroesophageal reflux: can irritate the respiratory tract and contribute to sinusitis.
Who Is Most at Risk?
Certain factors can increase the likelihood of developing sinusitis, including:
- History of seasonal or chronic allergies.
- Exposure to smoke or pollution.
- Frequent colds.
- Compromised immune system.
- Anatomical problems, such as a deviated nasal septum or enlarged adenoids in children.
Seasonality and the Relationship with Colds
Sinusitis is particularly common in autumn and winter when viral respiratory infections increase. It often develops as a complication of an untreated cold, progressing from simple nasal congestion to more serious inflammation.
How to Prevent Sinusitis
To prevent sinusitis, follow these simple precautions:
- Regular nasal irrigation: with saline solutions to keep the sinuses clear.
- Humidify the air: especially during cold months.
- Avoid smoking: as it irritates the mucous membranes.
- Treat allergies and colds promptly: with antihistamines or decongestants.
- Flu vaccination: to reduce seasonal infections.
How to Treat Sinusitis?
Treatment for sinusitis varies depending on the cause:
- Viral sinusitis: rest, nasal irrigation, hydration, and decongestants.
- Bacterial sinusitis: antibiotics, prescribed only if necessary.
- Chronic sinusitis: specialist evaluation with possible surgical interventions, such as endoscopic surgery to improve drainage.
- Complementary therapies: aerosol therapy or irrigations with hypertonic solutions to reduce inflammation.
Sinusitis and Multidisciplinary Support
Sinusitis often requires a multidisciplinary approach. At Aventino Medical Group, we offer support from various specialties:
- Allergy specialists: to identify underlying allergic rhinitis.
- Pediatrics: for sinusitis and ear infections in children.
- Neurology: for chronic headaches linked to sinusitis.
- Dentistry: for maxillary sinusitis related to dental problems.
- Cardiology: to monitor the impact of inflammation on the heart.
- Internal Medicine: for conditions such as lupus or autoimmune diseases.
- Gastroenterology: for gastroesophageal reflux contributing to the condition.
Frequently Asked Questions (FAQ) about Sinusitis
📌 What are the most common symptoms of sinusitis?
The main symptoms include nasal congestion, thick (yellow or green) discharge, facial pain or pressure, persistent headaches, reduced sense of smell, fever, fatigue, and bad breath (halitosis). In some cases, there may also be a sensation of pressure in the ears or ear pain.
📌 How can you distinguish viral sinusitis from bacterial sinusitis?
Viral sinusitis is more common and usually resolves on its own within 7-10 days, whereas bacterial sinusitis lasts longer and can cause more severe symptoms, such as high fever and persistent purulent discharge. If symptoms worsen after 10 days or do not improve, an antibiotic treatment may be necessary.
📌 What are some home remedies to relieve sinusitis?
For viral sinusitis, it is helpful to keep the nasal passages hydrated with saline rinses, use decongestants, drink plenty of fluids, and rest. Using humidifiers and inhaling steam can also help reduce inflammation and stagnant mucus.
📌 When should you see a specialist?
It is advisable to consult a doctor if symptoms last more than 10 days, worsen suddenly after initial improvement, or occur frequently. In cases of chronic sinusitis, an otolaryngologist can assess whether further treatments or interventions are needed to improve sinus drainage.
📌 Can sinusitis become chronic?
Yes, if inflammation lasts for more than 12 weeks, it is classified as chronic sinusitis. This condition may be caused by allergies, a deviated nasal septum, nasal polyps, or recurrent bacterial infections. In some cases, specialized treatment or surgical intervention may be necessary.
📌 Are there connections between sinusitis and other medical conditions?
Yes, sinusitis can be worsened or linked to respiratory allergies, dental problems, gastroesophageal reflux, and autoimmune diseases. In such cases, a multidisciplinary evaluation can help identify and address the root cause.
Conclusion: Managing and Preventing Sinusitis for Better Quality of Life
Sinusitis is a common condition that can significantly affect quality of life by making breathing difficult and causing persistent symptoms such as headaches, congestion, and fatigue. Recognizing the signs early and adopting appropriate prevention and treatment strategies is essential to avoid complications and improve respiratory well-being.
Adopting good habits, such as regular nasal rinses, avoiding exposure to smoke and pollutants, humidifying indoor air, and treating colds and allergies promptly, can help reduce the risk of recurrent or chronic sinusitis.
If symptoms persist for several weeks or recur frequently, consulting an ear, nose, and throat (ENT) specialist can help identify underlying causes and determine the most effective treatment. In some cases, the support of other medical specialists, such as allergologists, dentists, or internal medicine physicians, may be essential for a comprehensive evaluation of the problem.
📌 Maintaining respiratory health is key to overall well-being: proper sinusitis management helps you breathe better and enhances your quality of life.