Sinusitis : A common cause of Headache

Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. Newer classifications of sinusitis refer to it as rhinosinusitis, taking into account the thought that inflammation of the sinuses cannot occur without some inflammation of the nose as well (rhinitis).

Types Of Sinusitis: ( BY LOCATION)

Maxillary sinusitis - can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, headache) Frontal sinusitis - can cause pain or pressure in the frontal sinus cavity (located behind/above eyes), headache

Ethmoid sinusitis - can cause pain or pressure pain between/behind eyes, headache

Sphenoid sinusitis - can cause pain or pressure behind the eyes, but often refers to the vertex of the head

Acute sinusitis

Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Virally damaged surface tissues are then colonized by bacteria, most commonly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Staphylococcus aureus.
Other bacterial pathogens include other streptococci species, anaerobic bacteria and, less commonly, gram negative bacteria. Another possible cause of sinusitis can be dental problems that affect the maxillary sinus. Acute episodes of sinusitis can also result from fungal invasion. These infections are most often seen in patients with diabetes or other immune deficiencies (such as AIDS or transplant patients on anti-rejection medications) and can be life threatening. In type I diabetes, ketoacidosis causes sinusitis by Mucormycosis.
Chronic sinusitisChronic sinusitis is a complicated spectrum of diseases that share chronic inflammation of the sinuses in common. The causes are multifactorial and may include allergy, environmental factors such as dust or pollution, bacterial infection, or fungus (either allergic, infective, or reactive). Non allergic factors such as Vasomotor rhinitis can also cause chronic sinus problems. Abnormally narrow sinus passages, which can impede drainage from the sinus cavities, can also be a factor.
Symptoms include: Nasal congestion; facial pain; headache; fever; general malaise; thick green or yellow discharge; blurred vision, feeling of facial 'fullness' worsening on bending over; aching teeth.Very rarely, chronic sinusitis can lead to Anosmia, the inability to smell or detect odors.
A more recent, and still debated, development in chronic sinusitis is the role that fungus may play.
Predisposing Factors: deviated septum or small sinus ostia; smoking; nasal polyps; carrying the cystic fibrosis gene prior bouts of sinusitis

Treatment
Acute sinusitis
nasal irrigation or jala neti using a warm saline solution, hot drinks including tea and chicken soup, over-the-counter decongestants and nasal sprays, and getting plenty of rest. Analgesics (such as aspirin, paracetamol (acetaminophen) or ibuprofen) can be used, but caution must be employed to make sure the patient does not suffer from aspirin-exacerbated respiratory disease (AERD) as this could lead to anaphylaxis.
(Amoxicillin usually being the most common) with amoxicillin/clavulanate (Augmentin/Co-Amoxiclav) being indicated for patients who fail amoxicillin alone. Fluoroquinolones may be used in patients who are allergic to penicillinsDoxycycline is also used by some, for patients who are penicillin allergic

Chronic sinusitis
Simple measuresNasal irrigation and flush promotes sinus cavity z health, andpatients with chronic sinusitis including symptoms of facial pain, headache, halitosis, cough, anterior rhinorrhea (watery discharge) and nasal congestion found nasal irrigation to be "just as effective at treating these symptoms as the drug therapies." In other studies, "daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis," and is "recommended as an effective adjunctive treatment of chronic sinonasal symptoms.
Medical approaches
FESS - functional endoscopic sinus surgery, whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. This replaces prior open techniques requiring facial or oral incisions and refocuses the technique to the natural openings of the sinuses instead of promoting drainage by gravity, the idea upon which the Caldwell-Luc surgery was based
balloon sinuplasty
Endoscopic nasal Surgery allows more functional approach than by radical antrostomy. Intranasal endoscopic operations permits minimal trauma to adjacent tissues and precise removal of the diseased mucosa. intranasal inferior meatal antrostomy middle meatal antrostomy Caldwell-Luc radical antrostomy
ComplicationsIntracranial Complications -"meningitis""abscess",
Orbital Complications Orbital CellulitisOrbital Abscess
Vascular Complications -Infections aneurysms or infected blood clots in the intracranial cavity, both of which are potentially fatal.
Asthma Loss of Smell and Taste - ngs. Osteomyelitis