What are the risks involved when sinusitis goes untreated for long?

Sinusitis is defined as irritation of the sinuses by viruses or bacteria.  Sinuses are air-filled hollow cavities in the skull. When sinusitis occurs for at least 12 weeks, it is considered as chronic sinusitis.  The symptoms may include the inability to smell or taste the food, runny nose, throat irritation due to post-nasal drip and tenderness around the face. It may also cause difficulty in breathing due to prolonged blockage and swelling. Other symptoms may range from a headache, earache and also bad breath.

Sinusitis is common in patients with asthma, gastro-oesophageal disease (GERD), cystic fibrosis and Human Immunodeficiency Virus (HIV).

When left untreated for a long time, chronic sinusitis is associated with the following risks:

(1) A long term loss of ability to smell

This happens when there is temporary or permanent damage to the olfactory nerve that allows a person to be able to smell. The increased pressure in the skull will press on the olfactory nerve causing temporary or permanent damage to it.

When there is a loss in the ability to smell, the ability to taste is affected too. This is because, in the absence of smell, the taste buds are limited to a few flavors. In people with loss of sense of smell, they are reported to be having a higher level of anxiety and depression. This is because there is a loss of appetite as eating and drinking become difficult. Subsequently, weight loss occurs.

(2) Permanent loss of vision

It usually begins with sinus congestion and runny nose. The sinus congestion increases the pressure in the head. The rise in pressure may impact the circulation to the blood vessels of the eyes causing ischemia and subsequently blindness.

A severe form of this is called cavernous sinus thrombosis in which a blood clot forms in cavernous sinuses. The cavernous sinuses are air-filled hollow spaces located behind the eye socket. The blood clot forms to prevent further spread of bacteria to the body. However, the blood clot blocks the blood flow away from the brain, thus increasing the cavernous sinuses’ pressure which subsequently causes damage to the brain, eyes and the nerves in between.

(3) Infections in the brain

An untreated sinusitis infection will rarely spread to the brain or the tissues around it called the meninges. When these happen, symptoms such as seizures may occur. If it spreads to the meninges, it is called meningitis with symptoms such as neck tenderness, nausea, headache, and fever. Sometimes, it may spread to the brain causing brain abscess. All of these may lead to vision and hearing loss, stroke, brain damage as well as death.

 (4) Spread of infection to the skin or bones

Long term sinusitis or recurrent acute sinusitis may spread to the bone surrounding the sinuses. Infection of the bone is called osteomyelitis. Osteomyelitis may play a role in spreading further the infection into the blood vessels and the brain or other parts of the body.

(5) Formation of mucocele

A mucocele is a collection of mucus in the sinuses that will expand over time. The mucocele gives rise to increased pressure in the skull that may erode or herniate the facial bones to surrounding structures such as the brain and the eyes.

(6) Sepsis

In the case of cavernous sinuses thrombosis, the infection may continue to spread to the body, causing the poisoning of the blood or sepsis. Sepsis can be fatal if left untreated.

Read sinusitis answers by DoctorOnCall on the website for more information.

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