Risk Factors
Sinusitis is one of the most common diseases in the United States. According to the National Institute of Allergies and Infectious Diseases (NIAID), it affects an estimate 37 million Americans each year. However, a 2004 report in the Archives of Otolaryngology - Head and Neck Surgery suggests that sinusitis may not be as common as previously reported. The researchers found that accounts that rely solely on patient self-reporting may be exaggerated.
General Risk Factors for Sinusitis after a Cold
Everyone gets viral colds and flu, and most people develop symptoms in the upper respiratory tract (air passages in the head and neck) at some point. Over 85% of people with colds have inflamed sinuses. These inflammations are typically brief and mild, however, and only between 0.5 - 10% of people with colds develop true sinusitis. (One study suggested that nose blowing during a cold may transmit bacteria back into the sinuses and increase the risk for sinusitis.) Studies suggest that the following population groups have higher risks for sinusitis:
- The very young and the very old are at higher risk for more serious upper respiratory tract infections and for complications from them.
- Women appear to be at higher risk than men.
- People living in the Midwest and South have a higher incidence of sinusitis than those in the Northeast and West.
- People in higher income and educational groups appear to have a greater risk than those in lower groups.
- Caucasian and African Americans have a higher rate than Hispanic Americans.
Young Children and Sinusitis
Before the immune system matures, all infants are susceptible to respiratory infections, with a possible frequency of one cold every 1 or 2 months. Young children are prone to colds and may have 8 to 12 bouts every year. Smaller nasal and sinus passages also make children more vulnerable to upper respiratory tract infections than older children and adults. Ear infections such as otitis media are also associated with sinusitis. Nevertheless, true sinusitis is very rare in children under 8 or 9 years of age. Some experts believe it is greatly overdiagnosed in this population.
The Elderly and Sinusitis
The elderly are at specific risk for sinusitis. Their nasal passages tend to dry out with age. In addition, the cartilage supporting the nasal passages weakens causing airflow changes. They also have diminished cough and gag reflexes and faltering immune systems and are at greater risk for serious respiratory infections than are young and middle-aged adults.
People with Asthma, Allergies, or Both
People with asthma, allergies or both are at higher risk for non-infectious inflammation in the sinuses. The risk for sinusitis is higher in patients with severe asthma. People with a combination of polyps in the nose, asthma, and sensitivity to aspirin (called Samter's or ASA triad) are specifically at very high risk for chronic or recurrent acute sinusitis.
Hospitalization
Hospitalized patients are at higher risk for sinusitis, particularly those with:
- Head injuries
- Conditions requiring insertion of tubes through the nose
- Antibiotics or steroids treatment
- Breathing aided by mechanical ventilators (Such patients may have a significantly higher risk for maxillary sinusitis. In fact, treating sinusitis in such patients may significantly reduce the risk for ventilator-associated pneumonia.)
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