Acute Sinusitis: Diagnosis and Effective Treatments

Sinusitis is a common condition in Singapore, affecting most individuals at least once during their lifetime. While acute sinusitis can cause discomfort and interfere with daily activities, it is generally manageable with appropriate care and often resolves over time or with medical intervention.

What Is Acute Sinusitis?

Acute sinusitis, also known as acute rhinosinusitis, is a short-term swelling and inflammation of the lining of the paranasal sinuses. This condition can obstruct fluid drainage, resulting in mucus buildup. Most cases of acute sinusitis subside within 7–10 days. However, if a bacterial infection occurs, treatment may extend up to 4 weeks.

What Are the Risk Factors for Acute Sinusitis?

Acute sinusitis can affect anyone, but certain factors can increase the risk of its development. These include:

• Common Cold: Respiratory tract infections, such as the common cold, can cause the sinus lining to become inflamed or swollen.
• Structural Abnormalities: Nasal polyps or a deviated septum can restrict or block sinus passages, making it easier for infections to develop.
• Allergic Reaction: Allergies to pollen, dust mites, or pet dander can trigger allergic rhinitis (hay fever), which can lead to sinusitis when left untreated.
• Medical Conditions: Individuals with immune system disorders or autoimmune diseases, such as HIV/AIDS or cystic fibrosis, may experience sinus inflammation and congestion.
• Smoking & Pollutants: Tobacco smoke and environmental pollutants can irritate the sinuses and damage the respiratory tract, increasing the risk of infection.

What Are the Symptoms of Acute Sinusitis?

Individuals with acute sinusitis usually experience a range of symptoms, including:

• Nasal congestion or stuffiness
• Thick yellow or green nasal discharge
• Pressure and pain around the eyes, forehead, and cheeks
• Fever and fatigue
• Coughing or sore throat
• Reduced sense of taste and smell
• Bad breath or halitosis

How Is Acute Sinusitis Diagnosed?

To diagnose acute sinusitis, the doctor will ask the patient about their medical history and symptoms. Then, they will gently palpate the facial areas to look for signs of pain and tenderness or use a light source to examine the inside of the nose for inflammation, nasal polyps, or other abnormalities.

When the clinical presentation is ambiguous, doctors may recommend further tests to identify the underlying cause of acute sinusitis. These examinations include:

• Nasal Endoscopy: A thin, flexible tube with a light and camera at its tip is inserted into the nose to examine the nasal and sinus passages directly.
• Imaging Tests: The doctor may recommend an MRI or CT scan to detect any mucus blockages or abnormal structures in the nasal passages that may cause sinusitis.
• Allergy Test: If sinusitis is caused by an allergic reaction, the doctor may recommend a skin allergy test to help pinpoint the specific allergen that causes sinus inflammation.

What Are the Complications of Acute Sinusitis?

If left untreated, acute sinusitis can lead to severe complications, including:

• Chronic Sinusitis: Untreated acute sinusitis can develop into chronic sinusitis, persisting for more than 12 weeks and often requiring more intensive treatment.
• Meningitis: In rare cases, the sinus infection may spread to the membranes and fluid surrounding the brain and spinal cord, causing meningitis.
• Osteomyelitis and Cellulitis: Although uncommon, a sinus infection can extend to the bones (osteomyelitis) or the skin surrounding the sinuses (cellulitis), requiring urgent medical attention.
• Vision Problems: If the sinus infection spreads to the eye socket, it can cause reduced vision or permanent vision loss.

What Are the Treatment Options for Acute Sinusitis?

Typically, acute sinusitis resolves on its own within several days. At-home remedies, such as warm facial compresses and humidifiers, can also help ease discomfort and promote recovery.

If the symptoms of an acute sinusitis infection last for over a week, the doctor may prescribe other types of treatment to prevent further complications. Treatment options for acute sinusitis include:

• Medications: Over-the-counter medications, such as pain relievers, decongestants, antibiotics, and antihistamines, can reduce nasal swelling, pain, and inflammation.
• Allergy Shots: For individuals with allergy-induced sinusitis, the doctor may recommend allergy shots or immunotherapy, which introduces the body to allergens to build tolerance and reduce symptoms over time.

How to Prevent Acute Sinusitis

Individuals can lower the risk of an acute sinusitis infection or recurrence by adopting these tips:

• Eat a healthy diet rich in antioxidants to boost the immune system.
• Avoid cigarette smoke and other air pollutants.
• Minimise contact with individuals who have acute respiratory or sinus infections.
• Use a humidifier to help keep the nasal passages moist.
• Manage allergies with appropriate medications and minimising exposure.
• Maintain proper hand hygiene to reduce exposure to viral infections.

When To See a Doctor

While many cases of acute sinusitis resolve on their own, it is important to seek medical attention when experiencing:

• Symptoms that last more than 10 days without improvement
• Severe symptoms such as high fever, swelling around the eyes, confusion, or vision changes
• Recurrent episodes of sinusitis, which may indicate underlying issues.