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.
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Infectious sinusitis is caused by a bacterial, viral, or (rarely) fungal infection of fluid in the sinus cavities.
Factors that may increase your chance of sinusitis include: Recent viral infectionSmoking
or exposure to second-hand smoke
Other sources of indoor or outdoor air pollutionAllergies or asthma
Abnormalities of the facial bones, sinuses, or nasal passages, such as:
Deviated septumNasal polypsCleft palateLarge adenoids
Certain chronic illnesses, including:
Cystic fibrosisKartagener's syndrome (a chronic lung disease) and immotile cilia syndromeWegener's granulomatosis—rare disease that causes blood vessel walls to become inflamed
and other disorders of the immune system
or a medical condition requiring a tube to be inserted into the nose
Cocaine and other drugs inhaled through the nose
Sinusitis may cause: Facial congestion or fullnessFacial pain or pressure that increases when you bend over or press on the areaHeadacheCough, which is often worse at night
Nasal congestion not responding well to either decongestants or antihistaminesRunny nose or postnasal dripThick, yellow, or green mucusBad breathEar pain, pressure, or fullnessFeverFatigueDental pain
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 upCT 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 openingRemoving 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 mucusTenderness over the sinusesFeverDifficulty smelling
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.
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 is a last resort for people with very troublesome, serious chronic sinusitis. It includes: Repair of a deviated septumRemoval of nasal polypsFunctional endoscopic sinus surgery—a lighted scope is used to enlarge the sinuses to improve drainageBalloon sinuplasty—a tube with a balloon attached is inserted into the sinuses (the balloon is inflated to open the sinus passages)
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.
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Last reviewed August 2015 by David Horn, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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