Overview
Sinusitis is one of the most common conditions of the upper respiratory tract. The mucous membranes lining the air-filled cavities in the forehead, cheeks and around the nose become inflamed, usually following a common cold. The membranes swell, mucus can no longer drain properly, and a feeling of pressure develops in the face, which often intensifies when bending over. In most cases, acute sinusitis is caused by viruses and resolves on its own within two to four weeks. In an OpenClinic24 video consultation, the doctor takes a structured medical history: duration and course of the symptoms, location of the pain, accompanying symptoms and relevant pre-existing conditions. On this basis, and following the doctor's assessment, a therapy can be initiated, for example with decongestant or corticosteroid nasal sprays. Where indicated, a private prescription can be issued in accordance with the German medical fee schedule (GOÄ); billing is carried out as a private service for privately insured and self-paying patients.
Common causes
In most cases, acute sinusitis is triggered by viruses that initially cause a common cold. Swelling of the nasal mucosa narrows the passages connecting the nose to the sinuses, mucus builds up, and pathogens can multiply more easily. Less frequently, a bacterial superinfection develops in the course of the illness. Contributing factors include anatomical narrowing such as a deviated nasal septum or enlarged nasal turbinates, nasal polyps, allergic rhinitis – for example due to pollen or house dust mite allergy –, dental infections in the upper jaw, as well as smoking and dry indoor air. Anyone who is repeatedly affected or suffers from symptoms for longer than twelve weeks may have developed chronic sinusitis. In that case, further investigation is advisable in order to treat the underlying cause in a targeted way.
When to see a doctor
You can initially manage uncomplicated sinusitis with nasal rinses, steam inhalation and adequate fluid intake. Medical advice is warranted if symptoms last longer than ten days, worsen again after initial improvement, if fever above 38.5 °C occurs, or if there is severe one-sided facial pain. A medical assessment is also advisable in case of recurring episodes or suspected allergic causes. Visit a practice or emergency department without delay if you notice swelling or redness of the eyelids or forehead, visual disturbances, double vision, or severe headache with neck stiffness. In case of impaired consciousness, seizures or rapidly increasing facial swelling, call the emergency number 112 immediately. These signs can indicate a rare but serious spread of the inflammation to the eye socket or the membranes of the brain and require immediate in-person treatment.