
Rhinosinusitis
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What is rhinosinusitis or sinusitis?
Rhinosinusitis is defined as the disease that causes inflammation of the paranasal sinuses as an allergic response or due to the presence of a viral, bacterial, or fungal contaminant.
It is also known as sinusitis, although the term rhinosinusitis is more fitting as it is a condition characterized by rhinorrhea. Both terms are used interchangeably to refer to the inflammation and infection of the paranasal sinuses and nasal passages.
Inflammation of the paranasal sinuses can occur due to various causes and is identified by unmistakable symptoms: nasal discharge, nasal obstruction, facial pain, fever, among others.
Causes of Rhinosinusitis
As clarified at the beginning, the causes of rhinosinusitis are diverse, including:
Contact with infectious agents such as viruses, bacteria, or fungi.
Allergic reaction to an external agent.
Obstruction of the paranasal sinuses with excessive mucus.
Obstruction of the paranasal sinuses due to the presence of nasal polyps.
Hypertrophy.
Colds and allergies cause the body to produce too much mucus and irritability which causes inflammation of the sinuses.
Conditions that do not allow the paranasal hairs to expel mucus.
Altitude changes such as flying or diving.
smoking.
Allergic rhinitis.
The weak immune system for various reasons.

What are the symptoms of sinusitis?

The symptoms of this disease are similar for any case, whether allergic or bacterial, and include:
General discomfort, such as a continuous cold.
Fever.
loss of smell
Headache.
Pressure or pain in the face at the level of the nose and/or behind the eyes.
Sore throat and transnasal drip.
Runny or stuffy nose.
Cough that intensifies to sleep.
In children, the symptoms are perceived as a continuous cold that worsens, a dark discharge, and a high fever is also observed for several days.
Do you identify with the symptoms exposed? Do you think you need medical attention? Dr. Lech wants to help you find your well-being
Treatments for Rhinosinusitis.
There are two areas that need improvement through the treatment of rhinosinusitis: the infection causing it and the inflammation of the paranasal sinuses. Medicine has developed various treatments to achieve this.
Sinuplasty.
It is a surgical procedure aimed at dilating the ducts of the paranasal sinuses to eliminate discomfort caused by rhinosinusitis.
Symptomatic treatment.
This therapeutic approach focuses on relieving the symptoms of sinusitis rather than directly addressing its underlying cause. It is especially used when the root cause cannot be treated or when further testing is required to define the cause.
It aims to provide quick relief to the patient while other treatment methods are defined.
Pharmacological treatment.
Initially, the specialist physician will recommend pharmacological treatment with antibiotics and anti-inflammatory drugs to help alleviate the symptoms.
The recommendation is provided by a specialist physician who determines the dosage and frequency at which the treatment should be taken. It is important to follow these specifications strictly.
Endoscopic surgical procedure.
The endoscope is a tiny device that allows for minimally invasive surgeries. Thanks to these instruments, the patient can be treated without the need for incisions.
Using the endoscope, which consists of a camera and other instruments, obstructions of the paranasal sinuses are corrected through the nasal passages.
It is a quick procedure that does not pose major risks to the patient and can provide a solution for cases that do not improve with medication, including the removal of nasal polyps.
Types of sinusitis.
Rhinosinusitis can be classified as chronic sinusitis or acute sinusitis,depending on the duration of the condition. When a patient experiences it for a period equal to or less than four weeks, it can be considered an acute condition.
On the other hand, when the symptoms persist for more than four weeks, it is a chronic condition.
Identifying the type of sinusitis the patient is experiencing is important for recommending the ideal treatment.
Chronic sinusitis.
When the patient has inflammation lasting more than four weeks, the physician must differentiate the diagnosis based on the following variations:
Chronic rhinosinusitis with nasal polyps:
Nasal polyps are masses that form inside the nose and paranasal sinuses, obstructing breathing and the expulsion of secretions. They can be the cause of inflammation and the patient’s discomfort.
They are generally benign masses that need to be removed for improvement and represent another form of sinusitis.
Chronic rhinosinusitis without nasal polyps.
This refers to a condition that persists for more than six weeks, which in some cases can become recurrent sinusitis and affect the patient’s quality of life without the presence of nasal polyps.


Acute sinusitis.
When an condition lasts less than four weeks, the specialist physician will determine its cause based on the following variables:
Bacterial sinusitis.
Acute bacterial rhinosinusitis occurs when the patient comes into contact with bacteria, leading to a bacterial infection that results in irritating symptoms in the paranasal sinuses.
Characteristic symptoms include high fever, green and/or yellow nasal discharge, and a foul odor.
To determine this, the specialist doctor in otorhinolaryngology must perform a physical examination and complement it with other imaging tests such as endoscopy or tomography.
Viral sinusitis.
This disease is quite similar to the previous one, and it cannot be differentiated visually between viral and bacterial rhinosinusitis. Various studies, such as cultures, need to be conducted to differentiate them.
The symptoms are similar, and medical attention is necessary to find an effective treatment.
Frontal sinusitis.
It is characterized by inflammation and infection of the frontal sinuses, which are air-filled cavities located in the front part of the skull, just above the eyebrows and behind the forehead.
It can be caused by various factors, such as bacterial, viral, or fungal infections, allergies, nasal polyps, nasal duct obstruction, or an excessive inflammatory response of the immune system.
Diagnosis of Sinusitis
The diagnosis of sinusitis is made through a clinical evaluation performed by an otolaryngologist who may recommend the following options:
- Medical history: The doctor will ask questions about the patient’s symptoms, such as the duration, severity, and frequency of nasal congestion, facial pain, nasal discharge, fever, or other related symptoms. They will also inquire about the patient’s medical history and any preexisting conditions that may be relevant.
- Physical examination: The doctor will examine the facial and nasal area for signs of inflammation, congestion, discharge, or tenderness. They may palpate the paranasal sinuses to detect sensitivity or blockages.
- Nasal endoscopy: In some cases, a thin, flexible camera called a nasal endoscope may be used to examine the inside of the nose and paranasal sinuses. This allows for a more detailed visualization of the nasal mucosa and possible signs of inflammation or infection.
- Imaging tests: In certain situations, the doctor may request imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) to obtain more detailed images of the paranasal sinuses and confirm the diagnosis of sinusitis. These tests can help detect the presence of blockages, inflammation, or fluid accumulation in the sinuses.
In some cases, the doctor may consider it necessary to perform other tests or analyses to rule out other conditions that may have similar symptoms to sinusitis, such as allergies, nasal polyps, or dental infections, among others.
You can rely on Dr. Lech in Panama for the diagnosis and treatment of sinusitis.
Frequently Asked Questions about Rhinosinusitis
The organs affected by sinusitis are the paranasal sinuses, which are located around the face.
It refers to the inflammation of the paranasal sinuses caused by an allergic response.
Both terms are valid to define the inflammation that causes swelling of the paranasal sinuses, nasal obstruction, facial pain, and fever.
Yes, sinusitis can cause bad breath or halitosis in some people. The presence of an infection or inflammation in the paranasal sinuses can lead to the accumulation of mucus, bacteria, and other debris in the nasal cavity. These remnants can produce an unpleasant odor and contribute to bad breath.
Chronic sinusitis, especially when associated with a bacterial infection, can worsen bad breath.
Some habits or preventive measures can help reduce the risk of developing sinusitis. For example, quitting smoking and avoiding excessive alcohol consumption.
It is also important to consider our internal health to prevent fibrosis and tumor development in the area of the paranasal sinuses.
Avoiding exposure to contaminated waters or inhaling air in toxic environments that may lead to contact with infectious microorganisms.
Another point to consider is avoiding contracting colds or allergies as they are the main causes of sinusitis. In case of contracting a cold or allergy, it is advisable to treat them as soon as possible to avoid long-term nasal complications.
To prevent viral infections, we can increase the intake of antioxidants found in fruits, wash our hands frequently, avoid touching our face when we are away from home, minimize stress levels, and any other tool that helps keep our immune system strong.
Implementing habits such as increasing water consumption and using humidifiers with decongestant substances can keep the paranasal sinuses hydrated and in good condition.
The headache can be intense; if this is the case, prescription medications can be used to relieve it, inhaling steam can also be a great relief and drinking water.
In most cases, sinusitis can be cured with the recommendations mentioned above.
In the case of using a humidifier, plants like mint, peppermint, and eucalyptus can be added to enhance the decongestant effect. By decongesting and reducing inflammation in the area, we begin to find a solution to the condition.