From the Guidelines
Minor sinus disease, commonly known as sinusitis, is primarily caused by viral infections, bacterial infections, allergies, and structural abnormalities in the nasal passages, with viruses being the most common cause, often following a cold 1.
Causes of Sinusitis
The causes of sinusitis can be broken down into:
- Viral infections, which are the most common cause
- Bacterial infections, which typically develop after viral infections when mucus becomes trapped in the sinuses
- Allergens like pollen, dust, and pet dander, which can trigger inflammation
- Structural issues such as nasal polyps or deviated septum, which can block sinus drainage
Symptoms of Sinusitis
Common symptoms of sinusitis include:
- Facial pain or pressure, particularly around the eyes, cheeks, and forehead
- Nasal congestion
- Thick yellow or green nasal discharge
- Reduced sense of smell and taste
- Headache
- Fatigue
- Bad breath
- Sometimes fever Symptoms typically last 7-10 days for viral sinusitis and longer for bacterial cases 1.
Classification of Sinusitis
Sinusitis can be classified into:
- Acute sinusitis: symptoms for less than 4 weeks
- Subacute sinusitis: symptoms from 4 to 8 weeks
- Chronic sinusitis: symptoms for 8 weeks or longer
- Recurrent sinusitis: 3 or more episodes of acute sinusitis per year 1
Diagnosis and Management
Diagnosis of sinusitis is based on symptoms, physical examination, and imaging studies such as computed tomography (CT) scans. Management of sinusitis includes:
- Saline nasal irrigation
- Over-the-counter pain relievers like acetaminophen or ibuprofen (400-600mg every 6-8 hours)
- Decongestants such as pseudoephedrine
- Antihistamines for allergy-related sinusitis
- Antibiotics for bacterial infections that don't improve after 10 days
- Staying hydrated, using a humidifier, and avoiding irritants like cigarette smoke to manage symptoms and promote healing 1.
From the FDA Drug Label
1.3 Sinusitis – caused by beta-lactamase–producing isolates of H. influenzae and M. catarrhalis. The causes of minor sinus disease include beta-lactamase–producing isolates of Haemophilus influenzae and Moraxella catarrhalis. The FDA drug label does not provide information on the symptoms of minor sinus disease 2.
From the Research
Causes of Minor Sinus Disease
- Minor sinus disease can be caused by anatomic abnormality or chronic inflammation, which may be exacerbated by increased parasympathetic outflow or reduced sympathetic tone 3
- The ostiomeatal complex is a critical location where minor disease can give rise to greater symptomatology than diffuse disease in less critical sites 3
- Allergic rhinitis, facial trauma, or dental disease can also contribute to the development of minor sinus disease 4
Symptoms of Minor Sinus Disease
- Symptoms of minor sinus disease can include nasal and sinus pain, facial pain, and headache 3, 5
- Patients with minor sinus disease may also experience atypical migraine or vascular instability headaches 3
- The severity of symptoms can be out of proportion to the findings on physical examination, making diagnosis challenging 4
Diagnosis of Minor Sinus Disease
- Diagnosis of minor sinus disease requires a thorough evaluation, including nasal endoscopic examination and modified CT scans 3, 5
- Clinicians should distinguish presumed acute bacterial rhinosinusitis (ABRS) from acute rhinosinusitis caused by viral upper respiratory infections and noninfectious conditions 5
- The use of radiographic imaging should be limited to cases where a complication or alternative diagnosis is suspected 5
Management of Minor Sinus Disease
- Management of minor sinus disease should include an assessment of pain, with analgesic treatment based on the severity of pain 5
- Clinicians should educate patients on control measures, such as symptomatic relief and avoidance of triggers 5
- In some cases, minimally invasive surgery may be necessary to correct underlying causes of minor sinus disease 3