[Click! Health] Persistent Sinusitis... Treat It Before It Becomes 'Chronic'

Sinusitis, commonly referred to as 'chuknongjeung' in Korean, is an inflammatory disease caused by bacteria or viruses invading the sinuses, which are the spaces within the bones around the nose. The main causes include cold viruses, yellow dust, and pollen, but recently, the number of patients has surged due to factors such as air pollution and weakened immunity caused by stress.

[Image source=Clipart Korea]

According to the Health Insurance Review and Assessment Service on the 22nd, the number of acute sinusitis patients has nearly doubled over the past two years. The number of patients was 1,955,947 in 2021, increased by about 31% to 2,564,506 the following year, and then rose again by approximately 56% last year, reaching 3,994,297.

Sinusitis is generally known to occur frequently between winter and spring, but the incidence rate is also high from late spring to early summer. In May and June, daytime temperatures rise to levels reminiscent of summer, but mornings and evenings remain chilly, which can lower immunity. Additionally, exposure to yellow dust and fine dust continuing from early spring makes the bronchial tubes sensitive.

The sinuses are connected to the nasal cavity and function to ventilate air and discharge secretions. However, if the sinuses do not perform their role properly, purulent secretions accumulate, causing inflammation of the internal mucous membrane, leading to sinusitis. It mainly occurs in children and infants whose sinuses are not fully developed, and it is prone to recurrence and chronicity.

Sinusitis is classified into acute and chronic types; symptoms occurring within 4 weeks are considered acute, and if they persist for 12 weeks (3 months) or more, it is classified as chronic. Acute sinusitis presents symptoms such as nasal congestion, runny nose, fatigue, headache, mild fever, and facial pain, while chronic sinusitis mainly shows symptoms like nasal congestion, persistent yellow nasal discharge, and postnasal drip.

Acute sinusitis often resembles a cold, leading to delayed diagnosis and treatment. Especially if sinusitis is not detected in time and proper treatment is not administered, it can cause various complications such as periorbital cellulitis, epidural abscess, meningitis, brain abscess, osteomyelitis, and chronic sinusitis, making early diagnosis crucial. Diagnostic methods for sinusitis include simple medical history taking, nasal endoscopy, transillumination, biopsy, and computed tomography (CT). Transillumination involves shining a strong light into the sinuses and visually assessing the transmitted light pattern.

There is a clear difference in treatment between sinusitis and the common cold. Since the common cold is mainly caused by viruses, antibiotics are generally unnecessary except in rare cases suspected of bacterial infection. However, sinusitis is primarily caused by bacteria and requires a sufficient course of antibiotics. Therefore, if symptoms persist despite taking medications commonly used for colds, sinusitis should be suspected.

The basic treatment for sinusitis is medication therapy. Both acute and chronic sinusitis primarily involve antibiotic administration, and additional drug treatments may be combined depending on the disease progression and symptoms. Treatment of acute sinusitis aims to relieve symptoms and prevent chronicity and complications. Oral antibiotics are mainly used, typically administered for 10 to 14 days. With appropriate antibiotic treatment, clinical symptoms improve within 48 to 72 hours. Antibiotic administration is also the most important treatment for chronic sinusitis. However, if there is no therapeutic effect despite sufficient medication therapy, surgical treatment should be considered.

In addition to antibiotics, various adjunctive medications are used in sinusitis treatment. These include antihistamines, mucolytics, and topical steroids, which help improve nasal congestion and runny nose. Furthermore, lifestyle measures such as nasal irrigation with saline solution and humidity control using humidifiers can reduce mucus viscosity, enhance drainage and ciliary movement, and alleviate mucosal congestion. If symptoms do not improve and worsen, professional medical assistance should be sought.