Sinusitis: causes, symptoms and treatments

One of the most common seasonal illnesses is sinusitis. It occurs in winter and spring. Particularly during frequent changes in temperature or the pollen season. Although benign, this ENT condition can rapidly worsen without proper treatment, with the risk of becoming complicated or chronic. It is therefore vital to know how to detect the first signs and adopt the right measures to treat it effectively. The origin of the condition plays a crucial role in the choice of treatment: viral or bacterial, each type requires a specific approach. Here's what you need to know about sinusitis.

What is Sinusitis?

Sinusitis is a benign but common ENT disease. It affects around 15% of the population every year. It is an inflammation of the mucous membrane of the sinuses, causing congestion of the nasal passages. There are several types, depending on the precise location of the condition and its cause. In its infectious form, it may be associated with a cold. In other cases, the inflammation of the sinuses is allergic.

Medical advice will provide the right course of action to relieve the nasal problems caused by acute sinusitis and prevent it from becoming chronic. Antibiotic treatment is generally not necessary.

A word from the medical team

Sinusitis, in both children and adults, is generally benign and viral in origin, requiring symptomatic treatment rather than antibiotics. The initial treatment involves washing the nose with saline solution and taking a painkiller. If the symptoms persist or worsen after 3 days of well-administered treatment, the patient should be reassessed.

The different types of sinusitis

There are several types of sinusitis, caused by a variety of factors. It all depends on the type of sinusitis, how long it lasts and where it occurs.

Acute sinusitis

This is generally caused by a viral infection, although it can also result from bacterial superinfection, for example following a cold. The acute form is characterised by inflammation of the sinuses lasting up to 4 weeks.

It can cause intense headaches similar to those of a migraine, as well as a rise in temperature.

Chronic sinusitis

It is considered chronic when it lasts for more than 12 weeks despite attempts at treatment. Unlike acute sinusitis, which is often viral and resolves relatively quickly, chronic sinusitis can be caused by persistent infections, anatomical problems with the sinuses such as deviations in the nasal septum, allergy, or environmental factors such as repeated exposure to irritants (smoke, pollution, dust).

Classification according to location

Maxillary sinusitis

This is an inflammation of the maxillary sinuses, which are the largest of the paranasal sinuses, located on either side of the nose and in the area of the cheekbones. This form of sinusitis is one of the most common and can be caused by viruses, bacteria, fungi, allergies or blockages in sinus drainage.

Symptoms often include pain or pressure in the cheeks, teeth (particularly the upper teeth, which may feel sore or tender), and around the eyes.

Frontal sinusitis

If you have a headache on your forehead, you are probably suffering from frontal sinusitis. This is because the frontal sinuses are located above your eyebrows, on the forehead.

It mainly affects adults prone to rhinopharyngitis and children aged 10 and over.

Good to know: This condition can be aggravated by a deviated septum. In this case, surgery may be required.

Ethmoidal sinusitis

Here, the inflammation affects the ethmoidal sinuses, a group of small sinuses located between the eyes and behind the bridge of the nose. These sinuses play an important role in mucus drainage and are also involved in filtering and humidifying inhaled air.

Typical symptoms include pain and pressure around the eyes or along the sides of the nose. It can also lead to a headache, loss of smell, fever and sometimes a feeling of general malaise.

Sphenoidal sinusitis

This condition affects the sphenoid sinus, which is one of four pairs of paranasal sinuses located behind the nose in the centre of your skull, just behind the eyeballs. This type of sinusitis is less common than other forms of sinusitis, partly because the sphenoidal sinuses are smaller and less often affected.

It can cause severe headaches, often felt in the back of the neck or behind the eyeballs, pain or pressure at the top of the head, reduced sense of smell, and sometimes blurred or double vision if neighbouring nerve structures are affected.

Note: In infants and children under 5, acute ethmoiditis is a serious and painful form of sinusitis, affecting the ethmoid sinuses. The child presents with palpebral oedema (over the eyelids) and a temperature rise to over 39°C. Urgent medical attention is required: this is a therapeutic emergency that usually requires hospitalisation.

Is sinusitis contagious?

When sinusitis is infectious, which is the case in most cases, it is contagious. The viruses and bacteria linked to ENT infections circulate through micro-droplets of saliva and sneezing, among those around you, both at home and at work.

That's why it's important to take the right precautions to avoid infecting those around you. If you don't, you risk getting caught up in a vicious circle: your loved ones fall ill and then infect you again. To do this, wash your hands regularly, air rooms every day and blow your nose into single-use tissues that you then dispose of.

The symptoms of sinusitis

Common signs

Acute sinusitis generally manifests itself as:

• Congestion of the nasal passages;
• Clear or purulent discharge from the nose
• Sneezing;
• Moderate fever;
• Headaches of varying intensity;
• Pain in the cheekbones.

It is also possible to have sinusitis without a runny nose, depending on the location of the infection. Furthermore, if you have a purulent discharge, this does not necessarily indicate that the infection is bacterial in origin.

In addition to nasal problems and pain, other rarer symptoms may occur:

• Loss of smell;
• Bad breath;
• A hacking cough;
• Difficulty swallowing;
• Photophobia;
• Feeling of dizziness.

Symptoms depending on the location of the sinusitis

In the case of frontal sinusitis (from the age of 10), you will feel a pulsating pain under one eye, with a rise in temperature of over 38.5°C and discharge from only one nostril.

If you have acute sphenoidal sinusitis, the headache is more likely to be located behind the eye, and the discharge in the back of the nose. The pain is more intense at night.

Ethmoidal sinusitis is rarer but more serious. It manifests as oedema starting in the inner corner of the eye, which becomes painful and swollen (oedema). There is a high fever and a discharge from just one nostril.

Causes of sinusitis

Viral sinusitis

Most infectious sinusitis is viral in origin and therefore does not require antibiotics. They are most often maxillary sinusitis, affecting the sinuses in the cheeks. They can become superinfected and then bacterial.

Bacterial sinusitis

This can develop as a superinfection of a cold or appear directly. It may be frontal sinusitis, i.e. affecting the sinuses of the forehead.

Allergic sinusitis

Your sinuses may become inflamed and react to an aggressor, a substance or an allergen. In the latter case, a check-up by a specialist may be necessary. This can confirm an allergy to pollen, animal hair, house dust mites, moulds, chemicals, etc.

Once the allergen has been identified, you will receive appropriate desensitisation treatment to prevent a recurrence.

Aspergillosis sinusitis

This rarer, chronic form is caused by a fungus called aspergillosis. It develops in the sinuses, particularly in patients with an immune deficiency. Like maxillary sinusitis, this form of infection can be linked to a dental infection.

Dental sinusitis

Dental sinusitis can sometimes be caused by a problem with a tooth, such as a cavity or abscess. Some teeth are close to the maxillary sinuses. This is why the infection can spread.

How long does sinusitis last?

Acute sinusitis can last up to 4 weeks, depending on the case. If it recurs several times a year, it is called recurrent sinusitis. If the inflammation lasts for more than 3 months, it is called chronic sinusitis. Chronic sinusitis can cause severe fatigue.

How is sinusitis diagnosed?

Diagnosis often begins with a physical examination, during which the GP or ENT assesses the symptoms and may examine the nasal passages.

Additional tests, such as endoscopy or medical imaging (such as X-rays, CT scans or MRIs) may be necessary, depending on the case, to clarify the diagnosis.

Sometimes, a mucus sample is taken to identify a specific bacterial infection, in order to guide the appropriate treatment.

What treatments are available for sinusitis?

Medical treatments

If you have acute sinusitis of bacterial origin, treatment involves taking antibiotics, most often penicillin-based.

If symptoms persist, the doctor may adjust the prescription. Painkillers or antipyretics are used to relieve the associated pain and fever.

If there is an allergic cause, antihistamines are also prescribed to reduce sinus inflammation. The important thing is to avoid contact with the allergen in question as far as possible.

In some cases, the doctor may supplement the treatment with oral or nasal corticosteroids.

If the origin of the infection is dental, the treatment consists of treating both the causative tooth and the infection of the nasal mucosa.

In the case of a chronic form, if it is linked to an anatomical defect such as nasal polyps, surgery may be considered. This involves enlarging the sinuses and removing impurities and obstructions in your nose to limit complications such as recurrence.

Natural remedies to relieve viral sinusitis

Most sinus infections are viral in origin. Antibiotics are therefore generally not necessary to restore your health. You can, however, relieve most symptoms by taking the right steps:

• Wash your nose regularly with a seawater nasal spray or saline solution;
• Hydrate regularly;
• Avoid dry environments, especially air-conditioned rooms, and maintain a humid climate in your home;
• Inhale warm water to hydrate your mucous membranes;
• Avoid tobacco smoke;
• Avoid swimming or flying. This could delay healing and even cause severe pain.

Sinusitis during pregnancy

Sinusitis can also occur during pregnancy. In this situation, certain medicines may be contraindicated to ensure the healthy growth of the foetus. Here's how to proceed:

• Adopt the good habits described above;
• Do not self-medicate.
• Get some rest;
• Clean your nose regularly with a nasal solution such as saline solution;
• If you wish to use alternative medicine, ask your doctor for advice first.

We strongly advise against using essential oils. Some are contraindicated for pregnant women.

If necessary, your doctor can prescribe a medical treatment suited to your condition.

Tips to prevent the onset of sinusitis

Learning certain simple habits can help prevent the onset of sinusitis and protect your health:

• Disinfect your hands regularly;
• Use hydro-alcoholic gel and disposable tissues;
• Wear a disposable mask in crowded public places;
• Keep your rooms between 18°C and 20°C;
• Avoid dry air (particularly from air conditioning);
• Air the rooms in your home every day;
• Avoid chemical air fresheners;
• Limit contact with people who are ill as much as possible;
• Avoid contact with cigarette smoke and polluted environments;
• Take the necessary care to maintain good oral and dental health.

Frequently asked questions

How is sinusitis treated?

Treatment depends on the cause. It may include corticosteroids to reduce inflammation, nasal sprays to relieve congestion and antibiotics if the cause is bacterial. Nasal washes with a saline solution can also help clean the sinuses and facilitate drainage.

What are the consequences of sinusitis?

Untreated sinusitis can lead to complications such as eye, bone or brain infections, and can sometimes cause breathing problems or a diminished sense of smell. Possible complications include sinusitis becoming chronic, leading to a deterioration in quality of life due to persistent symptoms.

Does sinusitis cause fatigue?

Fatigue is one of the symptoms of sinusitis, particularly when it is chronic. Generally speaking, when we are ill, we are tired. Our body uses its energy to fight the microbes present. This can last from a few days to a few weeks in the case of acute sinusitis.

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