Chronic Sinus Infection

Understand the causes and  treatments available for chronic sinus infection.

Most people with chronic sinus infection have more than one factor which predisposes them to an infection.

Chronic sinus infection sufferers find that damp weather and places with a high concentration of airborne pollutants and molds affect them adversely.

Some people who are allergic to fungi can develop fungal sinus infection.

Top 10 Chronic Sinus Infection Symptoms

1. Nasal congestion. The causes of nasal congestion could arise from factors such as allergy to certain food groups, bacteria, pollens, fungus, other foreign matters and even the temperature of surrounding environment. Nasal obstruction can also be caused by changes in the anatomy of the nose. Enlarged turbinates(bony and soft-tissue structures) may also be excessively large to cause significant obstruction.

2. Nasal discharge. Mucus discharge could be clear or stained with pus which will give a yellowish green colour. It is also common to find a sudden mass of clear but thick mucus occasionally. If the mucus is foul-smelling, then the likelihood of the chronic sinus infection could be from a dental infection.

3. Postnasal discharge. This will be very pronounced especially on waking up in the morning. You will notice this because of the body's natural reaction to cough to clear the phlegm from the throat. Again, the mucus could be clear or coloured. This is one of the most obvious signs of chronic sinus infection.

4. Persistent cough. Usually, the cough is not very productive and if prolonged medication given to the patient by the general practioner is not effective, the patient is then referred to an ENT specialist for further investigation. This is especially so if a chest x-ray shows no signs of lung infection.

5. Blocked ears. Patients can get the feeling that one or both ears are blocked. When the mucus produced are in abundance and sticky in nature, there is a tendency for the eustachian tubes to be blocked. In really bad cases, eustachian tube dysfunction occurs. This is very uncomfortable as hearing is impaired. It must be emphasized that proper treatment must be initiated promptly otherwise ear infection follows. If the infection is allowed to prolong, then hair-cells within the ears could be destroyed resulting in some permanent hearing loss.

6. Teeth pain. The molars of the upper jaws can become sensitive when there is a chronic maxillary sinus infection. However, the pain felt is mild and not of the same severity as you would feel from a badly infected tooth.

7. Pain and discomfort in the forehead and cheeks. Depending on which of the sinuses are affected, sinus pain in the forehead close to the eyes, the cheeks just below the eye sockets and the areas just below the eyebrows closer to the bridge of the nose. These pains are associated with sinus pressure which are caused by the collection of mucus that cannot drain off.

8. Loss of smell. For very chronic cases of sinus infection, the loss of the ability to smell (Anosmia) can result.

9. Puffy eyes in the morning. On arising, both eyes will feel puffy and you would have difficulty in focusing. There is a tendency to squint your eyes a lot more when facing bright lights. This is yet another obvious chronic sinus infection symptom.

10. Fever and sore throat. If the chronic sinus infection is caused by fungus, the immune system is greatly impaired. The chief symptom would be frequent bouts of fever together with a nagging sore throat. The body feels extremely weak even when the fever has passed. 

Classification of Chronic sinusitis

Chronic sinusitis can be classified by one of the following paranasal sinuses:

Sphenoid sinuses are located behind the eyes. Chronic sphenoid sinus infection can cause very deep headache pain in the middle of the head, neck or up to the vertex of the crown.

Frontal sinuses are situated behind and above the eyes. As the name suggests, the frontal sinuses are located closer to the front surface than the sphenoid sinuses, for example.

Maxillary sinuses are located in the cheek area. Chronic maxillary sinus infection can be caused or made worse by infection of the teeth or gums.

Chronic sinus infection treatment

1. Antibiotics for Chronic Sinus Infection

If there is no abnormality of the nose structure, then prescribing antibiotics to treat the sinus infection would be appropriate. Antibiotics are classified as narrow-spectrum drugs when they work against only a few types of bacteria.

Broad-spectrum antibiotics, on the other hand, affect many types of bacteria. However, the use of broad-spectrum antibiotics presents the danger of promoting antibiotic resistance.

For that reason, narrow-spectrum antibiotics, which often cost less, are prescribed whenever possible. Broad-spectrum antibiotics are generally reserved for infections that are unresponsive to narrow-spectrum drugs.

For chronic sinusitis treatment, the ENT specialists would most likely prescribe a broad-spectrum antibiotic. Cedax®(Ceftibuten dihydrate) and Avelox®(moxifloxacin) are currently the best antibiotic for sinus infection.

Besides antibiotics, antihistamines and corticosteroids would be required as well to clear the allergy symptoms and inflammation respectively.

Telfast®(Fexofenadine), an antihistamine which does not cause drowsiness and Prednisolone®, a corticosteroid, are currently the preferred drugs prescribed to treat chronic sinus infection and for sinus relief.

2. Surgical procedure

In cases where there are structural abnormalities of the nasal passages such as a deviated septum, presence of nasal polyps and abnormally large turbinates, then surgery is implicated. The surgical procedure to remove part of the enlarged turbinates by way of cauterization to improve nasopharyngeal ventilation is known as "ablation of the turbinates".

Chronic sinus infection is a condition that is not as easy to treat. You should take special note to arrest mild cases of sinus infection early!