Definition

Sinusitis is inflammation of the sinus cavities. The sinus cavities are air-filled spaces in the skull. It is usually associated with infection.

Sinusitis is called acute if it lasts for less than 4 weeks, subacute if it lasts 4-12 weeks, and chronic if symptoms last for more than 3 months. You may have recurrent sinusitis if you have repeated bouts of acute sinusitis.

Sinus Infection

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Causes

Infectious sinusitis is caused by a bacterial, viral, or (rarely) fungal infection of fluid in the sinus cavities.

Risk Factors

Factors that may increase your chance of sinusitis include:

    
  • Recent viral infection
  • Smoking or exposure to second-hand smoke
  • Other sources of indoor or outdoor air pollution
  • Allergies or asthma
  • Abnormalities of the facial bones, sinuses, or nasal passages, such as:     
  • Deviated septum
  • Nasal polyps
  • Cleft palate
  • Large adenoids
  • Certain chronic illnesses, including:     
  • Cystic fibrosis
  • Kartagener's syndrome (a chronic lung disease) and immotile cilia syndrome
  • Wegener's granulomatosis—rare disease that causes blood vessel walls to become inflamed
  • Sarcoidosis
  • HIV infection and other disorders of the immune system
  • Diabetes
  • Head injury or a medical condition requiring a tube to be inserted into the nose
  • Cocaine and other drugs inhaled through the nose
  • Symptoms

    Sinusitis may cause:

        
  • Facial congestion or fullness
  • Facial pain or pressure that increases when you bend over or press on the area
  • Headache
  • Cough, which is often worse at night
  • Nasal congestion not responding well to either decongestants or antihistamines
  • Runny nose or postnasal drip
  • Thick, yellow, or green mucus
  • Bad breath
  • Ear pain, pressure, or fullness
  • Fever
  • Fatigue
  • Dental pain
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Sinusitis is diagnosed based on its symptoms and tenderness of the sinuses when pressed.

    Tests may include:

        
  • Holding a flashlight up to the sinuses to see if they light up
  • CT scan or x-ray of the sinuses to look for fluid in the sinus
  • Endoscopic examination of the sinuses—threading a tiny, lighted tube into the nasal cavities to view the sinus opening
  • Removing sinus fluid through a needle for testing (rare)
  • You have may acute sinusitis when the following occurs:

        
  • History of 10 or more days of colored mucous, or visibly infected mucus
  • Tenderness over the sinuses
  • Fever
  • Difficulty smelling
  • Treatment

    Home Care

        
  • Hydrating—Drinking lots of fluids may keep your nasal secretions thin. This will avoid plugging up your nasal passages and sinuses. Saline nasal sprays or irrigation may also loosen nasal secretions.
  • Using steam treatments—Keep a humidifier running in your bedroom. Fill a bowl with steaming water every couple of hours. Make a steam tent with a towel over your head. This will let you breathe in the steam.
  • Nasal and sinus washes.
  • Medications

        
  • Antibiotics—Used to treat bacterial infections.
  • Over-the-counter pain relievers.    
  • Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
  • Antihistamines—Help sinusitis symptoms if they are caused by allergies.
  • Intranasal corticosteroids—These are inhaled directly into your nose through a nasal spray. Corticosteroids may help relieve congestion by decreasing swelling in the lining of the nose in people with allergies.
  • Decongestants—Use either decongestant pills or nasal sprays to shrink nasal passages. Do not use nasal sprays for longer than 3-4 days in a row.
  • Guaifenesin—Helps you cough up secretions, but hydration is more effective.
  • Surgery

    Surgery is a last resort for people with very troublesome, serious chronic sinusitis. It includes:

        
  • Repair of a deviated septum
  • Removal of nasal polyps
  • Functional endoscopic sinus surgery—a lighted scope is used to enlarge the sinuses to improve drainage
  • Balloon sinuplasty—a tube with a balloon attached is inserted into the sinuses (the balloon is inflated to open the sinus passages)
  • Prevention

    To help reduce your chance of sinusitis:

        
  • Have allergy testing to find out what things you are allergic to and to learn how to treat your allergies.
  • Avoid substances you know you are allergic to.
  • If you have allergies, stick with your treatment plan.
  • If you get a cold, drink lots of fluids and use a decongestant.
  • Use sinus washes as directed.
  • Blow your nose gently, while pressing one nostril closed.
  • If you must travel by air, use a nasal spray decongestant to decrease inflammation prior to takeoff and landing.
  • Use a humidifier when you have a cold, allergic symptoms, or sinusitis.
  • Use HEPA filters for your furnace and vacuum cleaner to remove allergens from the air.
  • Avoid cigarette smoke.