Overview
Sinuses are hollow cavities within cheekbones, around eyes and behind nose. They contain mucus that helps to warm, moisten and filter the air breathed in. When something blocks the mucus from draining normally, an infection can occur.
Acute Sinusitis refers to sinusitis symptoms lasting less than four weeks. Most cases begin as a common cold. Symptoms often go away within a week to 10 days; but in some people, a bacterial infection develops.
Chronic Sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment.
People with allergic rhinitis or asthma are more likely to suffer from chronic sinusitis. This is because the airways are more likely to become inflamed when allergic rhinitis or asthma are present. Sinusitis may also be caused by an infection, a fungus, deviated nasal septum, nasal polyps or in rare cases an immune system deficiency.
Symptoms
Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include:
- Thick yellow-green nasal discharge
- Postnasal drip, often with a bad taste
- Cough
- Congestion
- Toothache
Diagnosis
Allergy testing can identify what allergic triggers might be behind chronic or reoccurring sinus infections.
In chronic or severe cases, a technique called rhinoscopy or nasal endoscopy may be used to examine nasal passages. In this procedure, a thin instrument is inserted up the nostril to view the sinus passages and look for blockages.
A CT scan can be used to look for abnormalities in the sinuses – narrow drainage passages, polyps or a deviated septum.
See a physician right away if the following symptoms are present: fever, pain or swelling in the face or eye, redness on the cheek or around the eye, severe headaches, confusion or a stiff neck.
Treatment
The treatment of sinusitis depends on the cause, severity and duration of symptoms.
Acute Sinusitis: Up to 70 % of people with acute sinusitis recover without any prescribed medications. If the cause is a bacterial infection, treatment with an antibiotic can shorten the duration of acute sinusitis and can also reduce the severity of symptoms. Other options for treatment include:
Decongestants or nasal saline sprays might help relieve symptoms and promote drainage of the infection.
Get plenty of rest, and keep body hydrated by drinking several glasses of water a day.
Over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) may be beneficial. Do NOT give aspirin to children under the age of 18.
In addition to medications, some people with sinusitis find relief by breathing hot, moist air, using hot packs or washing the nasal cavities with a saline rinse.
Chronic Sinusitis is typically not caused by a bacterial infection, so treating the condition with antibiotics usually does not help. Avoid activities and places that may aggravate symptoms—especially if they are allergy related.
Intranasal corticosteroid sprays or irrigations may be appropriate for recurrent sinusitis, but only under the care of a physician.
When medication treatments fail, endoscopic sinus surgery may be an option. This can be a very complex decision, which should be carefully weighted and discussed between patient, allergist / immunologist, and ear / nose/ throat doctor. Surgery should always be viewed as a last resort in children.
Sinus surgery is not a quick fix. Most patients who undergo sinus surgery will still need medical treatment to prevent the return of chronic sinusitis.