Chronic sinusitis

Chronic sinusitis is a continuous inflammation of the sinuses and adjacent cavities in the facial bones. A chronic sinusitis often develops from an acute sinusitis that manifests itself permanently over several weeks. Anatomical constrictions also often play a role in the development of chronic sinusitis. If you want to avoid medication as much as possible or reduce the amount of medication you take, a drinking and spa treatment at our Saxon State Spas is a good idea. Radon-containing water from one of our springs has been proven to reduce the symptoms.


What is chronic sinusitis?

In chronic, i.e. permanently manifested sinusitis, the cavities in the facial bones directly surrounding the nose are particularly affected - primarily the maxillary sinus and ethmoidal cells, more rarely the frontal sinus and sphenoidal sinus. Like the inside of the nose, the sinuses are covered by mucous membranes that are permanently inflamed and swollen in chronic sinusitis. This permanent inflammation often develops from an acute sinusitis in the context of a cold.

Acute sinusitis usually disappears by itself after about two weeks. However, if it lasts longer than 2 months or the symptoms return four times a year or more often, it is called chronic sinusitis. The symptoms are similar to those of acute sinusitis, but are permanent. From headaches and facial pain to purulent nasal secretions and coughing, the symptoms can vary in severity.

Symptoms of chronic sinusitis

Symptoms appear in various forms. Frequent are headaches and facial pain as well as a constantly congested nose and purulent nasal secretions. Coughing can also be an accompanying symptom of acute and chronic sinusitis. The general well-being is affected in a similar way to a cold. However, there are also people in whom the chronic sinusitis is only very mild and who hardly ever complain of symptoms, but even in this case the symptoms are permanent. A possible symptom or accompanying symptom of sinusitis is a disturbed sense of smell due to permanently blocked nose and sinuses.

Anyone suffering from chronic sinusitis makes it easy for new infections to occur, as the mucous membranes and immune system are already under strain. Postnasal drip syndrome and hyperreactivity are the secondary symptoms of permanent sinusitis. In postnasal drip syndrome, nasal secretions run into the pharyngeal cavity. In case of hyperreactivity, those affected tend to be particularly sensitive to fine dust, pollen, cold air or perfume and similar.


Causes of chronic sinusitis

A common cause is protracted acute sinusitis, which manifests itself chronically. Anatomical constrictions in the nose or sinuses can also be the cause of chronic sinusitis. This could be a deviated nasal septum, a large nasal concha or benign growths of the mucous membranes, which mean that the nasal secretion cannot drain properly.

This then leads to inflammatory processes, as pathogens remain in the sinuses for a longer period of time. A fungal infection can also cause chronic sinusitis. Viruses, on the other, hand are rarely involved in sinusitis.

People who suffer from allergies and/or asthma are particularly susceptible. In this group of people, acute sinusitis tends to heal less well and manifests itself permanently. The congestion of the nose often leads to benign mucous membrane overgrowth and inflammatory polyps.


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Symptoms of chronic sinusitis?

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Diagnosis: chronic sinusitis

Only your doctor can make a diagnosis. If your symptoms persist, first consult your family doctor, who will then refer you to an ENT doctor. The ENT doctor will first ask about your complaints and any accompanying symptoms. He will also tap you to locate the source of the pain. In addition, the ear, nose and throat specialist will perform a rhinoscopy to determine where the sinusitis is located. On this basis he can draw up the optimal treatment plan.

A rhinoscopy, also called nasal endoscopy, is performed in two steps. A nasal speculum is used to widen the nasal entrance slightly so that the doctor can examine the front part of the nose using a light source.

Nasal passages are about 7.5 cm long on average and the rear sections are not accessible with the speculum. However, a nasal endoscope, also known as a rhinoscope, enables these more inwardly located sections of the nose to be examined. This gives the doctor a detailed picture of the nasal mucosa, the nasal septum and the nasal concha. Pathological changes of the nasal secretion as well as deformities and inflammatory or tumorous changes as well as possible polyps can also be recognised in this way.


Risk factors of chronic sinusitis

There are some risk factors for chronic sinusitis which, either individually or in combination, do not necessarily lead to such a permanent sinusitis. A quite common cause is protracted acute sinusitis, which manifests itself chronically. Such a permanent fixation of inflammation is favoured by a curved nasal septum, as nasal secretion and thus the bacteria cannot run off well. Allergies and polyps as well as tumours in the nose or sinuses are also among the risk factors that can block the flow of nasal secretions.

Other risk factors that are related to the environment are, for example, swimming in waters that are polluted and have a high bacterial load, but also frequent contact with small children and thus exposure to cold germs. Smokers, even passive smokers, have an increased risk of chronic sinusitis because smoking thickens the nasal tissues and thus slows down the flow of secretions - consequently an optimal breeding ground for bacterial growth.

Questions around the disease

Your health insurance company will cover the costs of all necessary and appropriate diagnostic and therapeutic measures. For certain services, depending on the health insurance company and necessity, a self-cost coverage may apply.

If sinusitis persists for a long period of time, it is quite possible that bacteria or viruses involved in the sinusitis migrate into the lower respiratory tract. Bronchitis can therefore be a possible complication of untreated or severe chronic sinusitis.

In case of acute sinusitis, sport should definitely be avoided, otherwise the affected person risks that the acute sinusitis becomes chronic. In chronic sinusitis, if it is a mild form, moderate exercise is recommended because it improves the blood supply to the respiratory tract. Make sure, however, that you do not practice any sports during acute episodes. Also, otherwise you should not go up to your performance limit. To be on the safe side, ask your doctor to give you the OK. A few sessions with a physiotherapist can also help you find the best sport for your symptoms. Do sports outdoors, in winter and in dry air, make sure that your nose is protected from too cold air, e.g. with a scarf.

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