Respiratory diseases are more common in winter, and nasal congestion is a common symptom among people. Many people are troubled by repeated nasal congestion and taking cold medicine indiscriminately, which delays the treatment of sinusitis if the symptoms do not improve. If sinusitis is not treated in time, it may develop into chronic sinusitis, otitis media, and even intracranial infections. However, early identification and intervention, through standardized treatment and home care, the vast majority can be cured. How to distinguish nasal congestion and sinusitis caused by a cold? Dr. Wang Min, Chief Physician of Ear, Nose, Throat, Head and Neck Surgery at Peking University People's Hospital, reminds that these two diseases have similar symptoms, but their pathology and treatment plans are completely different. We will teach you precise identification in 5 minutes. Winter colds are more likely to cause sinusitis. Low temperatures and dry air in winter can weaken the resistance of nasal mucosa, making it easier for viruses to invade and cause colds. In addition, after catching a cold, the nasal mucosa becomes congested and swollen, blocking the channels between the sinuses and nasal cavity. The secretions in the sinuses cannot be discharged, and bacterial growth can lead to inflammation. In addition, winter haze and dust are abundant, continuously stimulating the nasal and sinus mucosa, exacerbating inflammation, and forming a cycle of "more blockage, more infection". Therefore, a cold in winter is more likely to cause sinusitis, especially in the elderly, children, and patients with allergic rhinitis. The probability of developing sinusitis after a cold is higher, and special attention should be paid to changes in symptoms. Moreover, in humid weather, even without catching a cold, sinusitis may still occur due to the dampness of the nasal mucosa and the growth of bacteria. The main symptoms are persistent nasal congestion and purulent discharge, decreased sense of smell, and significant bad breath. It worsens on cloudy days and slightly improves on sunny days. Nasal congestion for more than 7 days, beware of sinusitis. The core difference between common cold and sinusitis lies in the "lesion site" and "disease course": cold is an acute viral infection of the nasal mucosa, while sinusitis is inflammation of the bony cavity (sinus) around the nasal cavity, often developed from uncontrolled cold. 7 days is a critical turning point, remember two judgment points: if symptoms such as nasal congestion and runny nose persist for more than 7 days without improvement, or even worsen, it is likely to be sinusitis. After improvement, the symptoms of the cold worsen for 3 to 5 days, and then suddenly worsen after 6 to 7 days, such as worsening nasal congestion, nasal discharge turning from clear to yellow green purulent, and headache. This is a clear signal of bacterial infection secondary to the cold, causing sinusitis. Experts remind that after catching a cold, the main symptoms are "body aches, fever, and less obvious nasal congestion and runny nose", which can basically rule out sinusitis; But if it starts as a cold symptom, and later the overall symptoms improve, but nasal congestion, purulent nose, and headache worsen, you must be alert to sinusitis. At first glance, both colds and sinusitis have nasal congestion and runny nose, but the focus is completely different: colds tend to have "general discomfort+clear nose", while sinusitis tends to have "local discomfort+purulent nose". For example, in the early stages of a common cold, there may be clear nasal discharge, and in the later stages, there may be a small amount of white nasal discharge without any odor. The symptoms will improve with the treatment of the cold. Expert reminder: If the systemic symptoms improve after catching a cold, but nasal congestion, purulent nose, and headache worsen, be sure to be alert to sinusitis! Sinusitis has the following three "typical signals": 1. Yellow green purulent nasal discharge+difficult to blow purulent nasal discharge is the "core sign" of sinusitis, which is the inflammatory exudate of the sinus mucosa after bacterial infection. It is the yellow green, viscous purulent nasal discharge formed by bacteria stimulating the mucosa to produce a large number of neutrophils, which mix with secretions. It is rarely seen in the common cold. Expert reminder: Blowing your nose requires a lot of effort, and after blowing it, you may immediately experience bloody purulent discharge, which is a typical manifestation of sinusitis and indicates severe inflammation in the sinuses. 2. There is a clear "positional pattern" in the headaches of sinusitis, which is related to the anatomical location of the sinuses. Maxillary sinus syndrome often manifests as "cheek pain and toothache". This is because the maxillary sinus is located below the cheek, and inflammatory stimulation can cause cheek tenderness, which is exacerbated by muscle tension during chewing; Severe pain in the forehead upon waking up in the morning, gradually relieved after noon, possibly due to frontal sinusitis - the secretion of the frontal sinus accumulates at night. After waking up in the morning, the position changes, and the secretion stimulates the mucosa, causing pain. In the afternoon, partial discharge of the secretion reduces the pain; Swelling and pain in the base of the nose and inner corners of the eyes, possibly due to ethmoiditis; Pain deep behind the eyeball and back of the head may indicate sphenoid sinusitis, which can be mistaken for migraine. 3. The three symptoms of decreased sense of smell, bad breath, and nighttime cough are the "auxiliary signals" of sinusitis. Although they do not appear alone, they can be further confirmed by combining purulent nasal discharge and nasal congestion. The effect of "medication+care" has been confirmed for you. When flushing a cold with physiological saline, nasal congestion is quickly relieved and the effect can be sustained; However, sinusitis can only be temporarily relieved, but it will soon become blocked again and cannot solve headaches and purulent nasal discharge. Short term decongestants such as hydroxymethylazoline hydrochloride spray, such as colds, can quickly relieve nasal congestion after use, and the effect lasts for 4 to 6 hours; The relief effect of sinusitis is poor, not only does it recur quickly, but it may even worsen headaches. Experts remind that continuous use of decongestants should not exceed 7 days, otherwise it may lead to drug-induced rhinitis. Nasal hormones, such as mometasone furoate nasal spray, have limited effect on nasal congestion after a cold and can only slightly alleviate inflammation; For nasal congestion, purulent nasal discharge, and headache caused by sinusitis, the use of physiological saline flushing is more effective. Antipyretic drugs such as acetaminophen are used when fever is caused by a cold. After the body temperature drops, systemic symptoms will be relieved; Sinusitis is generally not used unless it is acute suppurative sinusitis or has complications. A brief summary of the above nursing procedures and the "three-step" home assessment: the first step is to rinse with physiological saline and observe whether the symptoms are relieved; Step two, if nasal congestion is obvious, short-term use of decongestants can be used to see if the effect persists; Step three, if the symptoms persist for more than 7 days, try using nasal steroids. The most likely effective treatment is sinusitis; Invalid or accompanied by high fever and severe headache, seek medical attention immediately. Experts remind that home medication can only assist in judgment and cannot replace formal treatment. For example, antibiotics must be used under the guidance of a doctor. Regularly flushing the nasal cavity with physiological saline, keeping warm, going out less on hazy days, quitting smoking and limiting alcohol consumption can effectively reduce the risk of disease. These situations require immediate medical attention. Some mild sinusitis can be relieved through standardized home care and medication treatment, but when the following "warning signals" appear, immediate medical attention must be sought and self judgment and treatment cannot be made. These signals indicate that sinusitis may be severe or have already developed complications. If treatment is delayed, it may lead to serious consequences such as hearing loss, chronic sinusitis, and even intracranial infections. The symptoms persist for more than 10 days and do not improve after medication; Body temperature exceeding 38.5 ℃, lasting for more than 2 days, accompanied by chills and poor mental state; Severe headache, affecting sleep, eating, and even nausea and vomiting; Severe ear pain, pus discharge, and significant hearing loss; Children may experience mouth breathing, severe snoring, lack of concentration, and facial swelling; Difficulty breathing, excessive purulent discharge, or accompanied by chest tightness, coughing up purulent phlegm; Repeatedly occurring multiple times within a year. Expert Reminder: If you experience severe headaches, nausea and vomiting, swollen eyes, or changes in vision, it may be inflammation affecting the skull or eyes. You must seek medical attention immediately, otherwise it may endanger your life! What tests may be performed after seeking medical attention? Nasal endoscopy is the most commonly used and basic examination for diagnosing sinusitis, which directly observes the inside of the nasal cavity and the opening of the sinuses through a thin tube with a miniature camera. Sinus CT examination is used to determine the type, severity, and extent of sinusitis when endoscopic examination cannot provide a clear diagnosis or surgical indications need to be evaluated. This provides a basis for developing treatment plans. It can clearly display the anatomical structure and pathological conditions of the sinuses, including whether there is fluid accumulation, mucosal thickening, and bone destruction in the sinuses. For patients with accompanying fever and chills, doctors will arrange blood routine and inflammation indicators (such as C-reactive protein and procalcitonin) tests to determine the type of infection. (New Society)