Cold that persists for 10 days or more may be sinusitis
Sinusitis is the inflammation of the layer that lines the nasal cavity and the sinuses, the mucosa. The most correct term is rhinosinusitis. The nasal mucosa has specific types of cells that contain eyelashes, which help to filter the impurities from the air, and glands that produce the mucus. Mucus has the role of humidifying the air, preventing microorganisms such as bacteria and viruses from attaching to our bodies and aiding in the cleaning of substances such as dust particles. The eyelashes are responsible for loading the mucus into the back of the nasal cavity, where it will be eliminated.
The sinuses (or paranasal sinuses) are air-filled spaces within the bones of the face, which are filled by very similar mucosa to the nasal mucosa. The mucosa of the sinuses also produces mucus, which is drained into the nasal cavity through holes. The origin of sinusitis occurs precisely in the blockage of this passage. Anatomical problems and inflammation of the mucosa near the orifices are the main culprits.
Among the anatomical alterations, we can mention the nasal septum deviation and the presence of nasal polyps. Foreign bodies, such as dental fragments inside the breasts, can also lead to inflammation of the mucosa. This usually occurs after tooth extraction and dental implant surgeries. The inflammation of the mucosa near the orifices occurs in the following situations: allergic and infectious processes.
Allergic rhinitis causes an inflammation, with consequent edema (swelling) of the nasal mucosa, which, in turn, does not allow mucus drainage . Viral infectious pictures, such as colds and flu, also lead to this inflammation. Without drainage, the mucus accumulates inside the sinuses, creating a culture medium for bacteria, which, when they proliferate, lead to sinusitis.
Some situations facilitate the occurrence of sinusitis. Both active and passive smoking are proven risk factors. Carriers of diseases such as cystic fibrosis, which changes mucus features, and ciliary dyskinesia, which impair the function of cilia, have recurrent patterns of sinusitis.
Sinusitis may be acute or chronic depending on the duration. Acute sinusitis is one that lasts up to 3 months. Symptoms of acute and chronic sinusitis are similar, but in the acute stage they tend to be more intense, with fever, fatigue, and pain in the body. In chronic sinusitis, nasal symptoms and coughing predominate.
Identifying symptoms anticipates treatment
The symptoms that define sinusitis are: nasal obstruction (stuffy nose), nasal discharge (phlegm that runs through the nose or throat), reduction or lack of sense of smell (hyposmia) and headache, fever and cough. In children, the symptoms of fever and cough predominate. As we can see, sinusitis manifests in a very similar way to viral pictures, such as colds and flu. What differentiates the two situations is the duration and intensity of the symptoms.
We must be alert for sinusitis when symptoms of a cold persist after 10 days or worsen after the fifth day. At this time, the evaluation of the otolaryngologist can confirm the diagnosis, which is clinical, based on symptoms and physical examination. X-ray examination of the face is not necessary for the diagnosis of sinusitis. The specialist will then assess the need for the use of antibiotics.
Recurrent use of antibiotics for recurrent or chronic sinusitis should also be investigated. In this case, additional tests, such as face tomography, may be needed.
In both allergic and viral infections, treatment aims to ease symptoms and prevent progression to sinusitis. Even when the disease is established, mild and initial cases can be treated with nasal corticosteroids and nasal lavage with saline solution. The current trend is the diminishing use of antibiotics, which should be indicated with caution by the risk of bacterial resistance. Important information is that nasal corticosteroids are safe medications, given to children from 2 years of age, and do not cause the side effects that oral corticosteroids can cause. And when the specialist indicates antibiotic treatment, early treatment will lead to a faster recovery.
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