Overview, Causes, & Risk Factors
Ethmoiditis refers to inflammation of the ethmoid sinuses.
What is going on in the body?
Within the facial skeleton are mucus-lined, air-filled cavities called paranasal sinuses. These are formed by the facial bones around the nose. There are 4 pairs of paranasal sinuses, including the ethmoid sinuses. These are honeycomb-like spaces between the eye sockets and nasal cavity. Each space is about the size of a matchbox. They contain small openings that drain into the nose. When the mucous membrane of the sinus becomes inflamed, it starts to swell. This leads to nasal blockage and mucus buildup.
What are the causes and risks of the condition?
The most common cause of ethmoiditis is an upper respiratory infection. Invading viruses attack the lining of the nose and sinuses. Other causes include allergies, structural abnormalities, and long-term bacterial infections. Fungal infections can occur in a person with a weak immune system.
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of ethmoiditis may include:
pain in the lower part of the forehead, between the eyes, and along the sides of the nose
mild redness and swelling around the corner of the eye
tenderness around the corner of the eye
difficulty breathing through the nose
loss of sense of smell
Diagnosis & Tests
How is the condition diagnosed?
The diagnosis of ethmoiditis is based on the person's history and a physical exam. Nasal endoscopy, an examination of the back of the nasal cavity using a narrow tool, is especially helpful. A CT scan can also show swelling of the sinuses.
Prevention & Expectations
What can be done to prevent the condition?
It is difficult to keep ethmoiditis from spreading. However, clearing nasal secretions may help prevent bacterial infections. Nasal clearing can be done by drinking lots of liquids, limiting milk, and rinsing out the sinuses with salt water. In the case of allergies, a person should avoid the things that cause allergic reactions. If there is chronic inflammation or infection, steroid nasal spray can help prevent some of the damage to mucous membranes that can occur over time.
What are the long-term effects of the condition?
If there is long-term allergic, bacterial, or structural involvement, the lining of the sinuses can thicken and block drainage. This can lead to chronic sinusitis.
What are the risks to others?
Ethmoiditis is not contagious.
Treatment & Monitoring
What are the treatments for the condition?
Symptoms from viral infections can be controlled with decongestants. For a person with allergies, antihistamines and decongestants are used.
Long-term treatment of ethmoiditis is based on the underlying disease. If chronic allergy is the cause, treatment includes oral antihistamines, mucus-thinning agents, topical steroids, and allergy shots. Recurrent or long-term bacterial infections require antibiotics. Surgery is required if the problem does not respond to medical treatment or is caused by structural abnormalities. For fungal infections, both surgical and anti-fungal therapies are required.
What are the side effects of the treatments?
Side effects are specific to the medication used. Oral decongestants may cause difficulty sleeping, increased heart rate, and nervousness. Oral antihistamines may cause drowsiness and dryness of the mucous membranes. Antibiotics can cause stomach upset and allergic reactions. Topical steroids are usually safe.
What happens after treatment for the condition?
There are usually no long-term effects after successful treatment of ethmoiditis. Someone with chronic inflammation will need long-term medical therapy. If the symptoms do not resolve, surgery may be recommended. Surgery is generally successful.
How is the condition monitored?
Monitoring is based on how serious the symptoms are and how long they last. Bacterial infection usually resolves with therapy. Rarely, it can spread to the eye socket or cranial cavity. For unknown reasons, adolescent males are at higher risk for ethmoiditis and require more careful monitoring. Any new or worsening symptoms should be reported to the healthcare provider.