Sinusitis

Sinusitis is redness, soreness, and swelling (inflammation) of the paranasal sinuses. Paranasal sinuses are air pockets within the bones of your face (beneath the eyes, the middle of the forehead, or above the eyes). In healthy paranasal sinuses, mucus is able to drain out, and air is able to circulate through them by way of your nose. However, when your paranasal sinuses are inflamed, mucus and air can become trapped. This can allow bacteria and other germs to grow and cause infection.

Sinusitis can develop quickly and last only a short time (acute) or continue over a long period (chronic). Sinusitis that lasts for more than 12 weeks is considered chronic.

CAUSES

Causes of sinusitis include:

  • Allergies.

  • Structural abnormalities, such as displacement of the cartilage that separates your nostrils (deviated septum), which can decrease the air flow through your nose and sinuses and affect sinus drainage.

  • Functional abnormalities, such as when the small hairs (cilia) that line your sinuses and help remove mucus do not work properly or are not present.

SYMPTOMS

Symptoms of acute and chronic sinusitis are the same. The primary symptoms are pain and pressure around the affected sinuses. Other symptoms include:

  • Upper toothache.

  • Earache.

  • Headache.

  • Bad breath.

  • Decreased sense of smell and taste.

  • A cough, which worsens when you are lying flat.

  • Fatigue.

  • Fever.

  • Thick drainage from your nose, which often is green and may contain pus (purulent).

  • Swelling and warmth over the affected sinuses.

DIAGNOSIS

Your caregiver will perform a physical exam. During the exam, your caregiver may:

  • Look in your nose for signs of abnormal growths in your nostrils (nasal polyps).

  • Tap over the affected sinus to check for signs of infection.

  • View the inside of your sinuses (endoscopy) with a special imaging device with a light attached (endoscope), which is inserted into your sinuses.

If your caregiver suspects that you have chronic sinusitis, one or more of the following tests may be recommended:

  • Allergy tests.

  • Nasal culture—A sample of mucus is taken from your nose and sent to a lab and screened for bacteria.

  • Nasal cytology—A sample of mucus is taken from your nose and examined by your caregiver to determine if your sinusitis is related to an allergy.

TREATMENT

Most cases of acute sinusitis are related to a viral infection and will resolve on their own within 10 days. Sometimes medicines are prescribed to help relieve symptoms (pain medicine, decongestants, nasal steroid sprays, or saline sprays).

However, for sinusitis related to a bacterial infection, your caregiver will prescribe antibiotic medicines. These are medicines that will help kill the bacteria causing the infection.

Rarely, sinusitis is caused by a fungal infection. In theses cases, your caregiver will prescribe antifungal medicine.

For some cases of chronic sinusitis, surgery is needed. Generally, these are cases in which sinusitis recurs more than 3 times per year, despite other treatments.

HOME CARE INSTRUCTIONS

  • Drink plenty of water. Water helps thin the mucus so your sinuses can drain more easily.

  • Use a humidifier.

  • Inhale steam 3 to 4 times a day (for example, sit in the bathroom with the shower running).

  • Apply a warm, moist washcloth to your face 3 to 4 times a day, or as directed by your caregiver.

  • Use saline nasal sprays to help moisten and clean your sinuses.

  • Take over-the-counter or prescription medicines for pain, discomfort, or fever only as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have increasing pain or severe headaches.

  • You have nausea, vomiting, or drowsiness.

  • You have swelling around your face.

  • You have vision problems.

  • You have a stiff neck.

  • You have difficulty breathing.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.