Sinusitis

Definition

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

Acute sinusitis lasts for less than three weeks. Chronic sinusitis is diagnosed when symptoms last for at least three 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 bacterial or fungal infection of the sinus cavities. The most common organisms to cause acute sinusitis include:

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis

Risk Factors

These factors increase your chance of developing sinusitis. Tell your doctor if you have any of these risk factors:

Symptoms

Symptoms of sinusitis may include:

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

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 are illuminated
  • CT scan or Xray of the sinuses to look for fluid in the sinus
  • Removing sinus fluid through a needle for testing (rare)
  • Endoscopic examination of the sinuses—threading a tiny, lighted tube into the nasal cavities to view the sinus opening

You have may acute sinusitis when the following occurs:

  • History of 10 or more days of colored mucus
  • Tenderness over the sinuses
  • Fever
  • Visible infected mucus in the nose
  • 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. Salt water nose 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

  • 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.
  • 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.
  • Antihistamines—Allergy medicines called antihistamines may help sinusitis symptoms if they are caused by allergies. However, they may also dry out the nose.
  • Guaifenesin—This medicine can help you cough up secretions, but hydration is more effective.
  • Antibiotics—Your doctor may decide to give you antibiotics if the infection seems to be caused by bacteria. Although, studies have shown that antibiotics are not effective in treating acute sinusitis.
  • Over-the-counter medicine—You can use acetaminophen , ibuprofen , or aspirin to treat sinus pain.
    • Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.

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)

If you are diagnosed with sinusitis, follow your doctor's instructions .

Prevention

If you have a tendency to get sinusitis following a cold or allergy attack, try these preventive measures:

  • 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, consider using cortisone nasal spray or antihistamines to decrease inflammation.
  • If you get a cold, drink lots of fluids and use a decongestant (either pills or nasal spray).
  • Sinus washes.
  • Blow your nose gently, while pressing one nostril closed.
  • Try not to fly in an airplane when you are congested. If you must fly, 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 High-Efficiency Particulate Air (HEPA) filters for your furnace and vacuum cleaner to remove allergens from the air.
  • Avoid cigarette smoke.

Revision Information

  • Reviewer:
  • Review Date: 09/2013 -
  • Update Date: 09/30/2013 -
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    http://www.entnet.org

  • National Institute of Allergy and Infectious Diseases

    http://www.niaid.nih.gov

  • Allergy Asthma Information Association

    http://aaia.ca

  • Calgary Allergy Network

    http://www.calgaryallergy.ca

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