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Everything about subacute sinusitis

Subacute sinusitis is a sinus infection and inflammation that lasts for some time, between 4-12 weeks. It can be confused with either acute or chronic sinusitis, but there is a slight difference between all three. Read ahead to find out more.

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Table Of Index

What is subacute sinusitis?

Risks & Complications

Should one consult a doctor for subacute sinusitis?

Treatment Overview

What is subacute sinusitis?

Subacute sinusitis is a complication of acute sinusitis that has extended for a long period of time but is still undergoing medical treatment. Its clinical presentation lies somewhere in between acute and chronic sinusitis, depending on how long the infection has been present. However, it is different from recurrent sinusitis as RARS occurs episodically, with no symptoms in between each episode of sinusitis. It is generally managed medically, but in some cases, surgical intervention may be necessary.

Types of disease

Causes

Common cold

Bacterial nasal/sinus infections

Fungal infection of the sinuses

Allergies

Symptoms

Thick mucus drainage from the nose and down the throat (runny nose and postnasal drainage)

Nasal congestion

Pain and inflammation around the eyes, cheeks, nose, and forehead

Ear pressure

Coughing/sneezing

Altered sense of smell

Fever

Headaches

Teeth pain

Diagnosis

Since subacute infections can lead to severe complications, they should be properly diagnosed and treated. Physical examination for subacute sinusitis starts with the patient’s medical history and illness history. Then, they will examine the patient to examine the severity of the symptoms.

Diagnostic tests for subacute sinusitis include:

Imaging tests: Imaging tests like CT and MRI scans help diagnose anatomical abnormalities like nasal polyps, deviated nasal septum, turbinate hypertrophy, etc., for swift treatment to avoid complications.
Nasal endoscopy: It is an effective diagnostic test for visualizing the nasal passages and paranasal areas to diagnose the severity of the condition and look for anatomical abnormalities in cases where treatment is not effective.
Allergy test: Skin allergy tests help narrow down the cause behind the patient’s condition to help treat the infections more accurately.
Nasal and sinus cultures: If the treatment hasn’t been effective, your ENT specialist may advise tissue cultures to prescribe more accurate and effective treatments. Tissue cultures help identify the exact causing organism behind the infection so that the doctor can prescribe narrow-spectrum antibiotics/antifungals instead of broad-spectrum medicines for more effective treatments.

Risks & Complications

Allergies with nasal effects, like hay fever, dust mites, pollen, etc.
Persistent bacteria, fungal or viral infections of the sinuses
Anatomical abnormalities affecting the flow of air in the nasal and paranasal passages
Diseases affecting the immune system, like cystic fibrosis, HIV/AIDS
Jobs like cleaners, metal workers, etc. that lead to chronic exposure to smoke
Smoking

Prevention
To prevent subacute sinusitis, the patient should get proper attention for their sinus infection. Most people ignore their sinus issues in the beginning stages, which causes them to get worse progressively. Therefore, the patient should manage their acute sinus infections as properly as possible. Some other preventive measures they can follow include:
- Wear a mask and carry a sanitizer with you to maintain proper oral hygiene.
- If you live in dry or arid regions, use a humidifier to add moisture to the air. Also, make sure your humidifier is clean and mold-free.
- Eat a balanced diet and hydrate well. You can add water, Gatorade, electrolytes, etc., to your diet.
If your sinus infection keeps getting worse, you should seek proper treatment to avoid chronic sinusitis and its complications.

Should one consult a doctor for subacute sinusitis?

Subacute sinusitis is a severe form of acute sinusitis, and you should consult an ENT specialist for treatment to avoid severe complications of the condition like:

Chronic sinusitis
Loss of smell sensation
Breathing difficulty
Larynx infection
Spread of the infection to skull bones, eyes, etc.

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Treatment Overview

Generally, most patients and ENT specialists prefer medical management for the treatment of subacute sinusitis. However, if the patient’s symptoms are too severe or if they are not improving at all, even with maximum medical management, surgical intervention may be necessary for sinus drainage and sinusitis recovery.

Medical management of subacute sinusitis includes a combination of medications like saline nasal sprays, nasal corticosteroids, nasal decongestants, allergy medications, over-the-counter painkillers, antibiotics, immunity shots, etc. In addition to these, the patient should follow at-home treatments like good hydration, wet & warm compresses, etc., to aid the progress of the patient’s recovery.

There are 3 main types of surgery that help recovery from sinusitis, as described below. However, the most common surgery for sinusitis is FESS due to its minimally invasive nature. Surgery treatments for sinusitis are:

Functional endoscopic sinus surgery (FESS)

FESS is an endoscopic surgery in which the surgeon inserts an endoscope and surgical instruments into the inflamed sinuses to drain and treat them. The surgery involves minimal damage to the surrounding tissues and provides swift recovery.

Balloon sinuplasty

During balloon sinuplasty, the surgeon uses an endoscope to insert a balloon into the infected sinuses. The balloon is gradually inflated to drain the sinuses and increase the size of the air passages.

Caldwell-Luc surgery

Caldwell Luc surgery is a traditional sinus surgery for maxillary sinusitis in which the surgeon makes an incision to make a new opening over the maxilla to gain access to the sinus cavity to drain the sinuses.