What Exactly is Sinusitis?

What Exactly is Sinusitis?

Healthy sinuses are covered with mucous membrane, moist, delicate tissue with microscopic moving hairs called cilia, covered by thin mucous. The nasal and sinus cilia move back and forth like tiny oars, constantly moving the mucous to flush the sinuses and nasal passages. The body is defended against foreign particles and pathogens in the air we breathe by this constant flushing.

When there is a blockage of the sinuses, or when the cilia fail to move the mucus, then an infection can occur. The cilia do not move the bacteria out of your body so they can multiply and make you sick.

In sinusitis, the sinus tissue is infected and inflamed. Bacteria are present. The tissues look swollen in the nose and in the sinuses on examination. The patient will have trouble breathing because of the blockage. Usually there is mild pain, fever and yellow or green discharge. Often the throat and chest are affected — with sore throat and cough.

Acute or Chronic?

Acute Sinusitis
Essentially in acute sinusitis you get over the attack fully. Might take a month but then you are clear. If we take an X ray at the start of the blockage, fever and pain, we generally see fluid in the sinus cavity, membranes are swollen, and there is severe swelling at the opening of the sinus cavities. If we take a repeat X ray later, the sinuses are now free of fluid, the swollen membranes are back to normal and the openings are no longer swollen and blocked. There is pain, nasal congestion, fever, and patient feels sick. Symptoms may resemble the flu, with weakness and aching. If the correct antibiotic is used, patient may get over this with the antibiotic. At the end of the infection, there is a great deal of yellow / green material that can be blown out or removed by irrigation.

Chronic Sinusitis
In Chronic Sinusitis, the symptoms have been present for 12 weeks or is the same infection that he had months ago but never fully recovered from. The point is that in chronic sinusitis, there is some problem that prevents effective treatment of the sinusitis. As we will see below, this could be due to antibiotic resistance, failure of the cilia, or any problem that causes blockage and prevents the sinuses from draining properly (sinuses with passages that are too narrow for whatever reason, sinuses that are swollen for reasons such as dental-related swelling, etc.). Even when the patient is feeling well, you can still see some membrane thickening and blockage of the sinuses. He may have symptoms secondary to the bacteria — asthma, cough, fever, fatigue.