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Causes of Sinusitis: Structural Abnormalities

Sinus caused due to 4 Changes

Sinusitis occurs when the sinuses become blocked. The sinus cavities create mucous on a continual basis. Under normal circumstances, mucous from the sinuses drains into the nasal passageways or into the back of the throat. When the sinus cavities are cut off from air and are unable to drain, an environment in which germs can grow and thrive is created. In most cases, especially those of acute sinusitis, the blockage is caused by excess or thick mucous.

Acute sinusitis lasts 4 weeks or less. Chronic sinusitis lasts 3 months or more. Sometimes chronic sinusitis is not caused by mucous but by tissue that blocks off the sinus cavities and prevents them from draining. This might occur because:

• tissue is abnormally enlarged
• there is scar tissue in the sinuses or nasal passageways from surgery or injury
• abnormal growths such as polyps
• An individual's inherited anatomy makes it difficult for the sinuses to drain.  

When tissue blocks the sinuses it often results in chronic sinusitis rather than acute and usually requires surgery to treat.

Enlarged Tissues

Structures can directly interfere with normal drainage of the sinus cavities. Also, because the back of the throat, the nose, sinuses, and ears are all connected, some conditions, for example, ear infections or fluid in the air, can be related to sinusitis. It is not uncommon for structures such as the adenoids or turbinates to become enlarged and contribute to sinusitis and other problems.

When the adenoids become enlarged, they not only block the sinuses, but often prevent the Eustachian tube from draining as well. This can lead to causing ear infections or fluid in the ear. In this case, an adenoidectomy may be necessary to resolve ear and sinus issues.

The turbinates are part of the nasal passageways and work to warm and humidify the air we breathe.

They can become enlarged and may need to be surgically reduced. Some people develop an air pocket in their middle turbinate called a concha bullosa, which can predispose them to sinus problems. Repairing the air turbinate requires surgery.

 Anatomy

Inherited anatomical differences can make some people more prone to develop sinusitis. For example, petite facial features can cramp structures in the face and make it more difficult for the sinuses to drain. This occurs more often in children who naturally have smaller sinuses and nasal passageways. Certain birth defects or genetic syndromes that affect facial structures, for example, cleft palate and down syndrome, can also increase the risk of sinusitis.

What Is Chronic Sinusitis?

Chronic sinusitis is sinus infection that lasts longer than 12 weeks. Sinusitis occurs when the sinuses become blocked and are unable to drain the mucous they continually produce. Stagnant secretions and lack of oxygen create an environment for microorganisms to grow. In the case of acute sinusitis, (sinusitis that lasts a month or less), the blockage is usually caused by excess or thick mucous combined with inflammation.

In the case of chronic sinusitis there may be underlying conditions which contribute to the development of sinusitis and make it more difficult to treat. While acute sinusitis can often be treated with a course of antibiotics, chronic sinusitis may require several rounds of antibiotics or even surgery to cure.

Most research agrees that there may be several underlying factors that contribute to the development of chronic sinusitis. We will talk about known conditions which cause or contribute to chronic sinusitis below.

Chronic Sinusitis From Structural Abnormalities

Structural abnormalities such as enlarged or diseased tissue which blocks the sinuses from draining can lead to chronic sinusitis and often requires surgery to treat. Examples are:

• enlarged adenoids
• enlarged turbinates
• concha bullosa
• nasal polyps
• deviated septum

Source:  Verywell