Sinus infection

Synonyms in a broader sense

sniff
flu
cold
illness
Sinuses

Medical: sinusitis

definition

Sinusitis (med. Sinuisitis) is usually the bacterial inflammation of the sinuses.
As a rule, it is the propagated infection of the nasal mucosa in a cold.

root cause

Since the Sinuses connected to the nasal passages, infections of the nose (sniff, Rhinitis) can also spread to the sinuses.
The mucous membrane of the paranasal sinuses also has a relatively low blood supply and its narrow openings make it very easy for secretions to accumulate in these cavities. With a bacterial infection, pus develops.
A collection of pus in the sinuses is then called Empyema.
Unhealed sinus inflammation (chronic sinusitis) can often become recurring (recurrent) Infections of the nasal cavity. The most common are the ethmoid sinus with their Ethmoid cells (Ethmoid sinus) and the Maxillary sinus (Maxillary sinus), more rarely the frontal sinus (Frontal sinus) and the sphenoid sinus (Sphenoid sinus) affected (see also anatomy Sinuses).

Symptoms

With sinusitis, you have pressing headaches, especially in the mornings and afternoons. The more strenuous activity, the more severe the headache, especially when we bend over. This is related to the fact that when bending down, more blood flows into the irritated mucous membrane due to gravity and this creates an uncomfortable feeling of tension and burning.

Toothache

Especially with inflammation of the sinuses of the upper jaw (Maxillary sinus) it can too accompanying toothache come. The main symptom of a sinus infection in this area is the throbbing pain in the cheek area, which can be aggravated by tapping the lower edge of the eye socket. You may experience headaches that increase when you bend over.

Due to the anatomical proximity of the lower edge of the maxillary sinus to the sensitive nerves of the teeth of the upper jaw the impression can arise that the complaint is a toothache. However, one should never make the mistake of automatically blaming a toothache on an existing sinus infection. Rather, a Abscess on the tooth root present, which in individual cases even favors a sinus infection. If in doubt, a dental clarification should be carried out.

diagnosis

The diagnosis is made by the physical examination and the Taking smears from the nasal secretion and the Nasoscopy (Rhinoscopy).
If there are complications in the treatment of sinusitis or if the disease is chronic or if surgery is planned for treatment, a MRI scan of the sinuses for more information about the inflammation. However, an MRI is not possible if the course is uncomplicated! necessary.

therapy

Acute sinus inflammation is treated with decongestant nasal drops or nasal sprays with the ingredients xylometazoline (Otrivin®) or oxymetazoline (Nasivin®).
They facilitate the discharge of secretions from the small openings in the paranasal sinuses.
After a week, however, the nasal drops / sprays should be discontinued, as otherwise our nasal mucous membrane will get used to continuous use and will no longer swell without it (privinism).
Some ear, nose and throat doctors (ENT doctors) also offer the option of suctioning off the purulent - inflammatory secretion directly. An insert with a decongestant medication in the nasal passage ("high insert") should also allow the mucus to drain off. The patient should inhale regularly himself at home.
Inhalations with chamomile vapor (Kamillosan®) or salt (Emser-Salz®) have an anti-inflammatory and also pleasant property.

After using decongestant nasal drops / sprays, nasal rinsing with a salt solution (Emser-Salz® solution) can cleanse the nose by rinsing out viscous secretions.
The saline solution also has a disinfecting and decongestant effect. In addition, after decongestant measures, the patient can be offered radiation with short waves, microwaves or red light on an outpatient basis. This is intended to stimulate blood flow and the healing of the inflammation.

The purulent sinus infection must also be treated with an antibiotic. If the sinus infection has still not healed after two weeks, the ENT doctor may recommend minor surgery. He will puncture the inflamed sinus and rinse it with a solution containing antibiotics.

Sinupret ®forte and Sinupret ® drops are used as herbal medicines.

Read more on the topic: Treatment of a sinus infection

Figure sinuses

Frontal sinus -
Frontal sinus
Ethmoid cells -
Cellulae ethmoidales
Maxillary sinus -
Maxillary sinus
Sphenoid sinus -
Sphenoid sinus
Thin septum -
Septum sinuum frontalium

You can find an overview of all Dr-Gumpert images at: medical illustrations

Medication

Treatment for a sinus infection should be three goals to have.

It should be achieved through treatment that the inflammation does not progress any further and comes to a standstill.
The mucous membranes in a Sinus infection thickened inflammatory should progressively decrease.
Appropriate Concomitant symptoms should be reduced.

On the one hand, this can be done with numerous alternative means be tried mainly by the Naturopathy are known. But also numerous conventional medical preparations can be used.
To the decongestion of the Nasal mucosa To achieve this, drugs come in most cases Active ingredient group alpha 1 Adrenergic agonists. The alpha adrenoreceptors are located in the vessels of the mucous membranes and cause them to contract Blood vessels in the area of the mucous membranes when a messenger substance is sent to the receptor docks. The substance Xylometazoline and their descendants are able to dock on precisely these receptors on the mucous membranes and achieve this corresponding effect.
Because of this, sinus infections occur Nasal sprays with this active ingredient to use. This begins as soon as the substance comes into contact with the mucous membrane to swell noticeably.

The administration of decongestant nasal drops also have some disadvantage. The main disadvantage is that relatively short duration of action, which makes frequent repetition necessary with almost 3-6 hours. To get the medication to the correct site of action in the nose To bring it, it is necessary to draw in the drops or the sprayed substance after application through the nose. Something Mucus secretionsAnything stuck will inevitably get to higher regions of the nose through this maneuver. With frequent repetition it can lead to a "Fix" the nasal secretion come in the nose, which then becomes a complication Suppuration of the sinuses.
Another disadvantage are the side effects of preparations containing xylometazoline. Especially with Long-term use it can happen that the effectiveness of the preparation decreases. Furthermore, there may also be a phenomenon that is called "Stinky nose" is known. This leads to a long-term use of nasal drops increasing drops of nose from the nose, either permanent or interrupted. The discharge usually has liquid to tough consistency and is by his foul smell characterized. Should this occur, the drug should be used immediately discontinued and a longer pause in treatment before resuming treatment.

In addition to the xylometazoline supplements come Medication used, mainly through their salty ingredients should try to make the nasal mucous membrane swell. Again in the form of Nasal sprays administered, saline substances are administered into the nose. The effect is not as quick as with the chemical products, but lasts for a similarly long time and does not involve the risk of the side effects mentioned. Furthermore is a time limit not described when using the drug. The salt composition can also in the form of an inhaler be given in the nose. By this achieved Droplet fogging it becomes possible that the salty substance often inhaled deeper can be and so partially deep into the Sinuses can penetrate and work.

Read all medications used for sinus infections under: Drugs for sinusitis

If a sinus infection does not heal after a few days, you have to chronic course can be assumed. This makes a slightly different treatment necessary. In the case of chronic courses of sinus infections, the once initiated decongestant treatment waived and rather the reason for the chronic form is treated. The reasons often lie in one allergic reaction. Especially the hardly avoidable house dust is often seen as the cause of chronic sinusitis. Nasal sprays can be used for this, which are a drug from the group of Antihistamines contain (especially with local treatment) or the antihistamine can be administered as a tablet. The major disadvantage of the treatment is that Side effects, which in the case of long-term use, especially in a increasing tiredness are justified.
In the case of chronic inflammation of the paranasal sinuses, one can also try the first actual inflammatory reaction to treat. Even if the actual cause of the chronic inflammatory reaction is initially ignored, one can try with the help of cortisone medication reduce the body's inflammatory response. Nasal sprays are also available for this. It can be severe and chronic systemic therapy be carried out with corticosteroid tablets. However, the numerous side effects should also be considered here. With long-term use, it can be Thinning of the skin get to increased blood sugar, to osteoporosis and adrenal insufficiency. However, this is only possible with long-term intake of high-dose cortisone. As a rule, chronic sinus infections are not treated in length and the cortisone tablets are not given in high doses. Besides the sprays you can also Drugs that accelerate ventilation are given. These are up for the most part vegetable based and have menthol, mint etc.

Antibiotic therapy

At persistent sinus infections, which persists despite the aforementioned drug treatment, treatment with a antibiotic be considered.
The decision as to whether one should be used is mostly made by the occurrence of severe and above all high accompanying fever attacks relieved and should definitely be initiated under these circumstances. This is where most antibiotics come in, like Cefuroxime or Amoxicillin for use. Especially with the bacterial acute sinus infection, by Pneumococci, Haemophilus influenzae, Moraxella catarrhalis, S. aureus, Streptococci or the so-called anaerobes should be named antibiotics Cefuroxime axetil, Cefpodoxime proxetil, Aminopenicillins or Levofloxacin are given. Alternatively, treatment with the so-called Macrolides done to those Clarithromycin and Azithromycin belong.

Treatment should consistently for 14 days be performed. As with all longer receipts, there can also be the classic side effects, such as. Diarrhea come. In principle, there is also the Risk of developing resistance of bacteria frequent and untargeted use of antibiotics.

Read our article on this: Antibiotic side effects

According to a recent study from the USA, antibiotic treatment has almost no advantages over purely symptomatic treatment. In this study, a group was involved Sinusitis sick patients were treated with symptomatic, purely decongestant therapy, the other group of patients who also suffered from sinusitis were treated with an antibiotic. The result showed that the patients of both groups recovered at about the same time and the Antibiotic groupe ka time recovery benefit compared to the symptom-oriented group. Whether this study is a Change of the treatment concept remains to be seen.

Basically, antibiotic therapy should (currently) be initiated if it is heavy and very long courses is about diseases. This is to ensure that if the Illness period not reduced will, at least the Minimized complication rate could be. Because one Spread of pathogens if you have sinus infections, antibiotic treatment is probably less likely.

Read more on this topic at: Treatment of a sinus infection with antibiotics

Treatment of sinusitis in homeopathy

You can find further information on the topic of treating sinus infections with homeopathy under our topic:

Homeopathy for sinusitis

For information on sinus infections and toothache, see below

Sinus infection and toothache

surgery

In most cases, sinusitis will heal with adequate, conservative (i.e. drug) therapy over a few weeks. However, in some patients it does frequent relapses or severe, long-lasting courses. This happens above all when, as described above, anatomical events or nasal polyps obstruct the discharge of secretion from the paranasal sinuses and thus favor the clinical picture. In these cases, surgery can help to significantly improve the recurring symptoms.

Nasal polyps are benign growths on the lining of the nose. In the so-called Polyposis nasi These growths occur in abundance and, in addition to nasal breathing, also hinder the self-cleaning mechanism of the nose. A Polypectomy, i.e. the removal of the polyps, can also help to relieve the sinuses.
This also applies to straightening a crooked nasal septum. Although the nasal septum is not absolutely straight in any person, gross deviations can lead to an obstruction of the drainage pathways from the sinuses and thus promote chronic sinusitis.

In particularly severe cases of sinusitis, it can happen that the bony walls of the sinuses are attacked in addition to the mucous membrane. This condition can lead to the dissolution of the bone substance and often requires surgical repair of the inflammatory focus.

Risk of contagion

Sinus infection is a viral or bacterial infection of the lining of one of the sinuses. The risk of contagion is depending on the type of causative agent different levels.

In the cold winter months in particular, acute sinus infections are often caused by so-called Rhinoviruses caused. These usually affect the nasopharynx and cause a sore throat, runny nose and, more rarely, bronchitis. An infection with rhinoviruses is no longer dangerous for the otherwise healthy patient, but there is a risk of infection for those around him. The viruses are sent via Droplet infection transmitted by sneezing or as a smear infection when shaking hands or through contact with infected objects.

If a viral infection is suspected, greater attention should be paid to personal hygiene. Sick and healthy people should wash their hands frequently, avoid contact between hands and face, and use disposable paper tissues to blow their noses. If the family has a disease, disinfectant spray helps to reduce the viral load on everyday objects.

This is rarer than the viral bacterial sinus infection. This is mostly due to a reduced outflow of the secretion, which is formed by the mucous membranes of the sinuses. This is sometimes colonized by bacteria, which results in an inflammatory state of the paranasal sinuses. Although the pathogens, which include staphylococci and streptococci as well as pneumococci and Haemophilus influenzae, can also be transmitted via the nasal secretions, they are usually not dangerous for healthy people.

A chronic sinus infection usually arises from secretion retention when the natural drainage channels of the nasal secretions are blocked. The chronic paranasal sinus is therefore due to nasal polyps and anatomical circumstances and for this reason not infectious. The same applies to chronic sinus infections in the context of an allergy.

Duration

General statements about the duration of a sinus infection are difficult to make. As a rough rule of thumb, one can assume that the acute form heals within twelve weeks. The chronic form exists beyond a period of twelve weeks and tends to recur frequently.

How quickly a sinus infection heals depends in detail on the type of therapy used and the discipline with which the therapy guidelines are followed. If there are accompanying symptoms such as anatomical deformities of the nasal cavity or accompanying diseases such as a pronounced infestation with nasal polyps, these can drag on the course of the disease.

Complications

An inflammation of the paranasal sinuses (sinusitis) can spread to the eye socket (orbit), as the limitation is only given by a wafer-thin bone plate.
A swelling of the upper eyelid, painful movement of the eyes and restricted viewing directions can be warning signals that this bone plate has ruptured. A dramatic case is when the skin around the eye is swollen, red, heated and painful (orbital phlegmon).

A sinus infection that has lasted more than three months is chronic (chronic sinusitis). Chronic sinusitis that can no longer be treated with antibiotic drugs (antibiotics) and rinsing should be treated surgically if necessary.

Read more on the topic: Superinfection

Forms of sinusitis

Maxillary sinus infection

As Maxillary sinus infection, called maxillary sinusitis in medical terminology, inflammation of the sinuses of the upper jaw (Maxillary sinus) designated. In most cases it can be traced back to an infection with viruses or bacteria and is occasionally favored by the obstruction of the natural drainage routes of the nasal secretion by nasal polyps or a deformed nasal septum. Allergies can also cause sinusitis. More rarely, the maxillary sinus infection can be triggered by an inflamed tooth root of the upper jaw.

The leading symptom of maxillary sinusitis is a pressing pain in the cheek areawhich can be reinforced by tapping the lower edge of the eye socket. Reddening of the cheeks can also be an outwardly visible sign of the disease. Often those affected complain pressing, throbbing headache. Toothache occurs occasionally. The pain usually intensifies when it is cold, whereas warmth is perceived as pleasant. The sense of smell and taste can be significantly restricted in the case of antritis.

Frontal sinusitis

In the Frontal sinusitis it is an inflammation of one of the two frontal sinuses, which are also called the frontal sinus. The triggering causes correspond to those of the other sinus infections. Kick if you have a frontal sinus infection a headache that are concentrated in the forehead of the affected side and may also affect the eye socket. Those affected complain of an increase in pain when bending over.

It becomes dangerous when the Inflammation spreads to the eye socket. Signs of this are the redness and swelling of the upper eyelid as well as the reddening of the entire eye socket and a painful restriction of movement of the eyeball on the affected side. This so-called Orbital phlegmon must be treated immediately in a specialist eye clinic in order to avoid late damage. Another potentially life-threatening complication the frontal sinusitis is the Meningitis.

Sphenoid sinusitis

The sphenoid sinuses are small air-filled cavities in the sphenoid bone (Sphenoid sinus) of the skull, which serve to reduce the weight of the cranial bone and as a resonance body for voice formation. As in all sinuses, an inflammation called sphenoid sinusitis can spread. The causes and the development of the disease correspond to those of the other sinus infections while the symptoms are rather unspecific.

First occurs more or less pronounced feeling of illness with oppressive headache. In sphenoid sinusitis, these are often localized in the back of the head and can become more pronounced when bending over. The Sphenoid sinusitis occasionally from a restriction of the sense of smell. In severe cases, purulent secretion can be emptied, which usually flows through the throat and is not immediately visible. Sphenoid sinusitis can also lead to a potentially life-threatening complication, meningitis. A medical examination and treatment is therefore justified in every case.

Sinusitis in pregnancy

In about a fifth of all women it occurs during pregnancy to a Swelling of the mucous membranes (Rhinitis of pregnancy). A sinus infection is not infrequently the result.

Often there are fears of harmful side effects of typical sinusitis medications such as antibiotics and decongestant nasal drops. However, inadequately treated sinus infections also harbor sinus infections Risks during pregnancy (e.g. a Miscarriage).

Home remedies such as herbal teas, steam inhalations or infrared light can be safely used during pregnancy and have a soothing effect on the symptoms of sinus infections.

Decongestant nasal drops are in pregnancy generally not recommended, very short-term use is justifiable if the symptoms are severe. Against it may natural nasal sprays for example with the active ingredient Dexpanthenol can also be used during pregnancy to moisturize the mucous membranes without side effects.

A bacterial infection (persistent symptoms, common fever) should also be used during pregnancy despite the possible side effects Antibiotics be treated. This is where the active ingredient group of Penicillins because these drugs can be taken relatively safely (even in the first trimester of pregnancy).

If the sinus infection is long-term or chronic, nasal sprays containing cortisone are an option, as they have a decongestant and anti-inflammatory effect. Since these active ingredients are only used locally as a nasal spray, they hardly affect the entire organism and can be used in lower dosage can also be used by pregnant women. However, the use should cortisone medication should be avoided if possible during the first three months of pregnancy.

Drug treatment of a sinus infection should never be avoided during pregnancy either. However, low doses of the medication and the combination with suitable non-medicinal measures to alleviate the symptoms are recommended.

Which medication (e.g. antibiotics) and which dosage are useful for a sinus infection during pregnancy should be agreed individually with the attending physician.

Sinusitis and exercise

It mainly occurs in the Autumn and winter months to a Sinus infection, should always be spared. The reason is that it is already weakened Immunsystem not to burden any further.

You have to imagine that Immune system taken by surprise by the infection and is overloaded at that moment (otherwise the disease would not have broken out).
When the body is slowly regenerating, the immune system works up Full speed to kill invading pathogens. An additional burden on the immune system would be the Slow down the recovery process and make the body even more susceptible to re-infection. Heavy work should be avoided.

Also at Sports, which is actually to be regarded as health-promoting, it comes to one slight decrease in the immune system, which in the case of an acute infection (here in the case of a Sinus infection) is not desired and would reduce the recovery process. Another danger of sport in acute infection is that Procrastination of pathogens that have entered the body. Even with a sinus infection it is for Entry of viruses or bacteria came. These pathogens mainly cause the described symptoms of inflammation of the paranasal sinuses locally.
If you do sport during this time, there is always the risk that the pathogens will be carried around in the body. One organ that can often be affected here is that heart and the Heart muscle as well as the heart valves. If the pathogen is spread, it can be dangerous Myocarditis (Myocarditis) come through the pathogens. Furthermore, it can also happen that the said pathogens attach themselves to a heart valve and are blocked there by vegetation Impairments to normal valve closure to lead. Two very dreaded complications of actually simple diseases.

Mostly young people who are going through an infection and who Not observing sports abstinence fail a short time later very high fever, fatigue and absolute weakness on. With existing Myocarditis or Valve malfunction there is also a dangerous one Decrease in cardiac output. An inpatient admission to the hospital must be carried out immediately and an immediate one antibiotic treatment initiated in order to avert the sometimes life-threatening course of the disease.
Failure to treat can lead to chronic and irreversible cardiomyopathy lead, under which a chronic heart failure is summarized due to the delayed infection. In the most severe cases, the mostly younger patients have to be put on a transplant list to get a Donor heart to obtain.