What is Sinusitis?

Sinusitis (clinically known as rhinosinusitis) is an inflammation of the tissue lining of the sinuses that afflicts more than 35 million Americans each year. Normally, the sinuses are filled with air, but when sinuses become blocked and filled with fluid, pathogens (bacteria, viruses and fungi) can grow and cause an infection. Structural issues such as narrowed drainage anatomy are often associated with sinusitis.

Sinus Anatomy:

There are four types of sinuses – frontal (in the forehead), ethmoid (between the eyes), sphenoid (behind the eyes) and maxillary (behind the cheek bones). All of these sinuses can be affected by sinusitis. The majority of sinusitis cases involve the maxillary and ethmoid sinuses.

Symptoms of Sinusitis:

There are many symptoms of sinusitis including sinus pain and pressure, discolored nasal drainage, bad breath, facial congestion/fullness and pressure, nasal obstruction/blockage, fever, headaches, and fatigue.

Types of Sinusitis:

Otolaryngologists (ENT physicians) divide sinusitis into these types:

Acute rhinosinusitis (ARS) is an outbreak of sinusitis symptoms lasting 7 to 10 days and can be triggered by a number of things including a virus or cold, allergies or environmental factors and anatomical irregularities.

Chronic rhinosinusitis (CRS) describes a persistent (twelve plus weeks) swelling of the sinus and nasal drainage pathways that prevents normal sinus drainage, leading to a build-up of mucus, infection, and the painful symptoms associated with sinusitis. In many chronic sinusitis cases, medical therapy (antibiotics, pain relievers, over-the-counter decongestants) fails to correct the underlying obstruction preventing drainage and causing infection and discomfort.

A less common form of CRS, recurrent rhinosinusitis (RARS) has signs and symptoms of acute bacterial rhinosinusitis occurring 4 or more times in a one-year period with no sinusitis symptoms between periods. Sufferers are stuck in a repetitive cycle of outbreaks, sometimes suffering through symptoms many times a year.

Impact on Quality of Life and Productivity:

The quality of life impact for those who suffer from chronic sinusitis can be significant ranging from missed work to detachment from family and social life to fatigue from loss of sleep. In studies comparing individuals with chronic conditions, sinusitis patients scored worse in measures of bodily pain and social functioning (ability to engage fully in social activities with friends and family) than patients with congestive heart failure. The impact of sinusitis on productivity is significant. One study estimates that sinusitis contributes to 61.2 million lost workdays annually, at an opportunity cost to employers of almost $18.3 billion. Another study looking at a sample of large U.S. employers characterized sinusitis as one of the top ten most costly conditions for employers.

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