From the Research
Chronic mild to moderate ethmoid and maxillary sinusitis can cause dizziness in some patients due to the inflammation and pressure changes affecting the vestibular system and eustachian tubes. This occurs through two primary mechanisms: disruption of the vestibular system due to inflammation near the inner ear, and barometric pressure changes within the sinus cavities that affect balance perception. The inflammation from sinusitis can spread to nearby structures, potentially affecting the eustachian tubes that regulate middle ear pressure. Additionally, the congestion and fluid buildup in the sinuses can create pressure changes that impact the vestibular system. Some key points to consider in the management of sinusitis-related dizziness include:
- Treatment typically involves addressing the underlying sinusitis with saline nasal irrigation, intranasal corticosteroids like fluticasone (2 sprays per nostril daily) or mometasone, and in some cases, antibiotics if bacterial infection is present 1.
- Decongestants may provide temporary relief but shouldn't be used long-term.
- If dizziness persists despite sinusitis treatment, it's essential to consult a healthcare provider to rule out other potential causes, as dizziness can sometimes stem from separate vestibular or neurological conditions that coincide with sinusitis.
- The relationship between chronic ethmoidal sinusitis, maxillary sinusitis, and ostial permeability is complex, with studies suggesting a link between ethmoidal sinusitis and maxillary ostial dyspermeability in cases of chronic maxillary sinusitis 2.
- The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis is diverse, with both aerob and anaerob bacteria present, which can inform treatment decisions 3. However, the most recent and highest quality evidence on the topic of antibiotics for acute maxillary sinusitis suggests that antibiotics provide a small benefit for clinical outcomes in immunocompetent primary care patients with uncomplicated acute sinusitis, but about 80% of participants treated without antibiotics improved within two weeks 1.