We are searching data for your request:
Upon completion, a link will appear to access the found materials.
Inflammation of the sinuses - sinusitis
Inflammation of the sinuses (sinusitis) is often the result of a cold, but can also be caused by other factors, such as anatomical peculiarities. The first form occurs as an acute illness and heals without complications in most cases with appropriate care. Sinus infections due to anatomical peculiarities are often associated with a chronic course of the disease.
The term sinus inflammation encompasses all inflammatory processes in the area of the maxillary sinus (maxillary sinus; located in the maxilla on both sides of the nose), the frontal sinus (frontal sinus; located above the nose in the frontal bone), the ethmoid cells and the ethmoid labyrinth (ethmoid sinus: small cavities in the ethmoid bone between the nose and inner corner of the eye) and the two sphenoid sinuses (sphenoid sinus; located behind the ethmoid cells in the sphenoid bone).
A distinction must be made between acute and chronic sinus infections. Furthermore, the sinus infections are differentiated according to their localization into the ethmoidal sinus (affected ethmoid cells), frontal sinusitis (inflammation of the frontal sinus), maxillary sinusitis (inflammation of the maxillary sinus), sinusitis sphenoidalis (inflammation of the sphenoid sinus) and the pansinusitis, in which all sinuses are sinuses.
Symptoms of acute sinusitis
The symptoms of acute sinusitis, despite many similarities, differ significantly in detail from the chronic forms. In most cases, acute sinusitis is preceded by a cold or a runny nose. The secretion formed cannot run properly due to anatomical peculiarities, such as a crooked nasal septum, or due to swelling of the mucous membrane and accumulates in the sinuses. This affects the maxillary sinuses more often in the acute forms. In the remaining sinuses, the acute inflammation is much less common.
The typical cold symptoms such as runny nose, cough, hoarseness, body aches and fever can often be observed as accompanying symptoms. Many sufferers also complain of headaches.
Characteristic of the sinus infection are the oppressive pain in the area of the inflamed sinuses. The pain increases as soon as the head is bent forward or held down. Depending on the location of the sinuses, the pain can localize behind the forehead, in the jaw and cheek area or behind the eyes. Occasionally, the discomfort is also associated with a toothache.
If the head is tilted forward or the patients lightly hit the back of the head with the flat of their hand, the pain in the inflamed sinuses can usually be clearly localized. In the course of the disease, the pain can increase significantly and become almost unbearable for those affected. General complaints such as tiredness and fatigue are added. Loss of smell and visual disturbances may be part of the clinical picture of acute sinusitis. Sometimes the inflammation can be recognized as swelling on the face. The nasal secretion of those affected appears yellow-greenish due to the amount of pus.
Symptoms of chronic sinusitis
Chronic sinusitis is when the discomfort persists for two months or more. The ethmoid cells and the maxillary sinuses are affected more often. Without therapeutic treatment, the chronic sinusitis does not heal permanently and reappears a few weeks to months after the alleged disappearance.
The pain associated with this can represent a considerable impairment in everyday life for those affected, even if the complaints are often perceived less intensely in the case of a chronic course than in the case of acute sinus infections. In addition, there is a persistent loss of odor, chronic runny nose (usually watery and not yellow-greenish) and a subliminal feeling of pressure in the area of the affected sinuses.
The patients often perceive a permanent outflow of nasal secretions in the throat. Chronic sinusitis is often associated with the proliferation of so-called polyps on the mucous membranes. These have a reinforcing effect on the clinical picture, since they in turn hinder the outflow of secretions. It is not uncommon for the chronic form of sinusitis to be accompanied by an asthma disease.
In the worst case, inflammation threatens to destroy the bone walls that surround the sinuses. The purulent secretion can get into the eye socket or even into the brain, including bacteria. Massive damage to the eye and life-threatening inflammation in the brain or meninges are possible consequences here.
Cause of acute inflammation of the sinuses
When it comes to the causes of acute sinus inflammation, colds should be mentioned first. The nasal mucous membranes and the mucous membranes of the sinuses swell significantly during the course of a cold, which can lead to blockages in the tiny connections between the nasal cavity and the paranasal sinuses. The self-cleaning mechanism of the mucous membranes (cilia on the mucous membranes transport nasal secretions together with dirt particles and potential pathogens towards the nasal cavity) is disturbed in this way and the secretions that are built up accumulate in the sinuses.
At the same time, the affected sinuses are no longer ventilated. The environment offers pathogens good conditions for reproduction. Viruses and bacteria can thrive here and in turn attack the mucous membranes. Since inflammation of the nasal mucosa (rhinitis) and inflammation of the paranasal sinuses usually occur together, the term "rhinosinusitis" is often used in the professional world.
Bacterial infections that can cause sinusitis are usually due to pneumococci, streptococci or staphylococci. The Chlamydophila pneumoniae bacteria from the genus Chlamydia can also trigger the disease. In children under the age of five, bacterial infection of the sinuses with Haemophilus influenzae type b is particularly feared. Bacterial inflammation of the paranasal sinuses usually passes a little faster than virally caused diseases and is often only observed one-sidedly.
Inflammation of the sinuses is increasingly caused by flu viruses (influenza viruses), parainfluenza viruses and rhinoviruses. Adenoviruses, coronaviruses, enteroviruses and respiratory syncytial virus (RSV) can also cause acute sinusitis. The symptoms can usually be observed on both sides and often last longer than with bacterial infections.
Causes of chronic sinus infections
The chronic forms are usually based on an anatomically caused disruption of the secretion drain. For example, a curvature of the nasal septum (septal deviation) can impair ventilation of the paranasal sinuses and promote secretion build-up. Germs spread more and more in the poorly ventilated sinuses and may cause inflammation of the mucous membranes. The sinus mucous membranes then increasingly produce secretions that, in the worst case, accumulate and further promote the growth of germs.
In addition to chronic sinusitis, those affected more often suffer from otitis media and corresponding ear pain.
Another cause can be impaired ventilation of the sinuses and secretion drainage disorders due to benign growths of the mucous membranes - so-called polyps. In rare cases, tumors form, which cause the connections between the sinuses and nasal cavity to narrow. If the symptoms are increasingly associated with nosebleeds, special caution is advised here.
Other causes of sinus infection
It is not uncommon for allergic reactions to cause inflammation of the mucous membranes in the nose and sinuses. For example, hay fever promotes the occurrence of sinusitis.
Sinus infections are one of the typical symptoms of an intolerance to pain medication (intolerance to the active ingredient acetylsalicylic acid, contained in aspirin, ASA or ibuprofen, for example). Individual drugs, such as the active ingredient raloxifene, which is used to prevent osteoporosis in postmenopausal women, can in turn cause sinus infections as a side effect in unfavorable cases. In addition, the inflammation may originate from the teeth or the tooth roots or the upper jaw. This variant is called "dentogenic sinusitis".
Sinusitis due to Churg-Strauss syndrome
In rare cases, inflammation of the sinuses is the result of the so-called Churg-Strauss syndrome (CSS). In the course of the disease, inflammatory processes take place in the small blood vessels, which are due to an excessive increase in the so-called eosinophilic granulocytes. While the causes of the syndrome are still largely unclear, the symptoms have been researched relatively extensively.
A distinction is made between three stages of the CSS: the onset with increased allergic runny nose and bronchial asthma, the subsequent eosinophilic inflammation of the lungs and the digestive tract, and the third stage of the disease, systemic vascular inflammation (vasculitis) of the small blood vessels. Sinus infections are a typical accompanying symptom of CSS. Heart problems also frequently occur, which can be connected with a stinging in the chest, heart pain or chest pain, rapid heartbeat and heart stumbling. In the worst case, a heart attack threatens.
Cause yellow nail syndrome
Another rather rare cause is the so-called yellow nail syndrome (YNS). Little is known about the development of the disease here either. Characteristic are thickened toenails and fingernails due to a growth disorder. The nails take on a yellowish color. At the same time, those affected often suffer from fluid retention in the chest and so-called lymphedema (intracellular fluid retention), but also from recurrent sinus infections.
As part of the diagnosis, a detailed medical history is required, in which the patient reports on the symptoms and possible previous illnesses. Palpation of the nose and face can provide further important information for the diagnosis of sinusitis. This is followed by a first simple examination of the nasal cavity (rhinoscopy) with the help of a headlamp and a nasal speculum, which is inserted into the nose and carefully spread to allow a look into the inside of the nose. Swelling of the nasal mucosa, but also anatomical features, such as a curvature of the nasal septum, can be recognized relatively easily in this way.
In order to determine diseases located deeper in the nasal cavity, nasal endoscopy is recommended. The inserted endoscope can not only be used to look into the posterior nasal cavity, it can also be used to take tissue samples (biopsy) that help to confirm the diagnosis. Minimally invasive interventions are possible as part of nasal endoscopy, in which polyps are removed, for example.
Blood tests provide other important clues to identify possible causes of sinus infection. They can allow conclusions to be drawn about the triggers of existing inflammations and possibly existing rare diseases such as Churg-Strauss syndrome.
To make a clear diagnosis, imaging methods such as sonography (ultrasound examination), X-ray examinations, computed tomography (CT) and magnetic resonance imaging (MRI) are helpful, whereby computed tomography is the means of choice today to determine sinus inflammation.
If an allergy is suspected to be a trigger, a nasal provocation test may be appropriate. This involves first measuring the breathing resistance of the nasal breathing (rhinomanometry) in the normal state. The nose is then sprayed with a solution of diluted allergens and, after a certain period of time, the breathing resistance is measured again. If this increases significantly, this is an indication of a possible allergy.
A loss of smell caused by sinusitis can be determined with the help of a so-called olfactory test. The measurement of the olfactory evoked potential is available as an objective method. Last but not least, this method is rarely used in practice due to the enormous effort involved. Instead, a subjective olfactory test is usually carried out, in which those affected should recognize certain distinctive odorants. So-called olfactory sticks with different smells, such as coffee smell, vanilla smell or menthol smell, are held in front of the patient's nose. Difficulties in identifying the odorants indicate that the sense of smell is impaired.
Treatment of sinusitis
Treatment should be based on the cause of the symptoms and can vary considerably accordingly. For example, if antibiotics are helpful for a bacterial infection, they have little effect on viral sinus infections. In the case of acute inflammation of the sinuses, an attempt is first made to remedy the swelling of the mucous membranes in order to allow normal secretion drainage and adequate ventilation of the sinuses. Decongestant nasal sprays are a common procedure here.
In the case of allergic diseases, nasal sprays based on antihistamines and glucocorticoids are used. In general, however, caution should be exercised with nasal sprays, as they can damage the nasal mucous membranes sustainably and a kind of dependency develops with prolonged use. The so-called hyposensitization (formerly desensitization) can possibly completely eliminate the allergic reaction. Those affected are regularly exposed to low doses of the allergens in order to get used to them and to avoid overreacting the immune system.
Treatment of sinusitis often attempts to liquefy the nasal secretions to facilitate their outflow. Different procedures and medicines are supposed to solve the mucus. Inhalations, nasal douches, infrared treatments and numerous herbal active ingredients are used here.
To this day, surgery is often the only way to permanently fight sinus infection. This applies in particular to anatomically caused inflammations. Straightening the nasal septum and removing the polyps are among the relatively common procedures performed, but are associated with corresponding operational risks.
Surgery is often required even for malignant tumors. If cancer is the cause of the sinus complaints, the classic instruments of cancer therapy - radiation and / or chemotherapy - may come into play in addition to the operations. In the course of treating Churg-Strauss syndrome, chemotherapy drugs are also used in rare cases.
If the patient complains of severe pain due to the sinus infection, pain-relieving preparations can be administered in addition to the different therapies.
Naturopathy for inflammation of the sinuses
Alternative medicine offers numerous approaches to naturally treat sinus infections. These range from aromatherapy, mother tinctures from the field of herbal medicine, Schüssler salts and homeopathy, to acupuncture and manual treatment methods such as Rolfing or osteopathy.
Nasal irrigation with saline is considered to be a suitable adjunctive therapy, especially for chronic sinusitis. The positive effects of orthomolecular therapy (high doses of vitamins and minerals), which may also be used for sinus infections, are less clear.
Kneipp applications in the field of hydrotherapy are helpful and beneficial for inflammation of the sinuses. Experts especially recommend inhaling, because this combines the positive effects of medicinal herbs or essential oils with the soothing effects of heat stimuli. A steam bath with chamomile, for example, is very suitable because it has an anti-inflammatory and expectorant effect.
- Bring 2 to 3 liters of water to a boil
- Place a handful of dried chamomile flowers or 4 bags of chamomile tea in a heat-resistant bowl
- Pour the boiling water over it
- Hold your face slightly above the bowl and place a towel over your head and bowl so that the water vapor cannot escape from the sides
- Breathe in the vapors with your eyes closed for about 10 minutes
- Then wash off the face with lukewarm water and apply cream carefully
In mineral therapy with Schüßler salts, for example, potassium chloratum (Schüssler salt No. 4), Silicea (No. 11) and Kalium sulfuricum (No. 6) are used for the treatment. As with most inflammatory diseases, a connection with the acid-base balance or a possibly existing acidity is also suspected in sinusitis. Appropriate regulation of changing the diet or intestinal rehabilitation is therefore often part of naturopathic treatment.
Natural treatment with medicinal plants and aromatherapy
For example, the so-called Myrtol takes advantage of the positive effects of individual plant ingredients. The remedy is made from eucalyptus oil, myrtle oil, sweet orange oil and lemon oil. The high concentration of essential oils (limonene, cineol and pinene) has an expectorant effect when taken and promises relief from acute sinus infections.
Other essential oils also have a positive effect. This includes mixtures based on gentian root, verbena, garden sorrel herb, elderflower and cowslip flowers. Furthermore, the ingredients of the chamomile flower and the horseradish are to be mentioned as herbal active ingredients against the inflammation of the sinuses. Drinking herbal tea (e.g. based on chamomile, thyme, sage or ribwort) alleviates the symptoms and is considered a proven home remedy for colds and sinusitis.
Prevention of sinus infection
In terms of prevention, all measures that generally strengthen the immune system are recommended. Above all, this includes a healthy, balanced diet, sufficient sleep, regular exercise, lots of fresh air and the reduction of negative stress. In order to calm down and relieve tension, various relaxation exercises and techniques for reducing stress are suitable, e.g. Yoga or autogenic training.
Avoid tobacco consumption as much as possible because the smoke attacks the mucous membranes. In winter, the head should be kept as warm as possible and sufficient air humidity should be provided in heated interiors.
If you already have a cold, it is particularly important to blow your nose properly. Affected people should be careful not to apply too much pressure, otherwise secretions will be pressed into the sinuses. Ideally, only one nostril should be blown at low pressure while the other remains closed with the finger. The procedure is then repeated for the other nostril.
A proven home remedy for colds is inhalation with table salt or the addition of essential oils to clear the nose and facilitate the outflow of the secretion. At the same time, those affected are advised to drink a lot of herbal tea or water (at least two liters a day). (fp, nr)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
- Annette Kerckhoff, Michael Elies: What to do in case of sinus infection: Naturopathy and Homeopathy, KVC Verlag, 2015
- Pschyrembel Online: www.pschyrembel.de (access: 06.09.2019), sinusitis
- Working group of the Scientific Medical Societies (AWMF) e.V .: www.awmf.org (call: 04.09.2019), Odontogenic maxillary sinusitis: Register number 007 - 086
- Bruce Arroll: "Antibiotics for upper respiratory tract infections: an overview of Cochrane reviews", in: Respiratory medicine, Volume 99 Issue 3, 2005, Respiratory medicine
- Hans-Georg Boenninghaus, Thomas Lenarz: Otorhinolaryngology, Springer, 2012