Sinusitis – Causes, Symptoms, Diagnosis, And Treatment
What is sinusitis?
Sinusitis or sinus infection is inflammation of the cavities around the nasal passages. The sinuses are air-filled spaces or cavities located behind the forehead, nasal bones, cheeks, and eyes. This condition occurs as the result of an infection from a virus, bacteria, or fungus.
There are two types of sinusitis: acute sinusitis and chronic sinusitis. Acute sinusitis is when symptoms are present for four weeks or less. Chronic sinusitis is when the inflammation of the sinuses is present for longer than three months.
What causes sinusitis?
Sinusitis is caused due to an infection caused mostly by a virus. Sometimes, bacteria and fungus infection can also cause sinusitis.
The following conditions can also cause sinusitis:
- Small hairs (cilia) in the sinuses fail to move mucus out properly; this may be due to some medical conditions.
- Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
- A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
The following conditions or factors may increase the risk of developing sinusitis:
- Allergic rhinitis or hay fever
- Cystic fibrosis
- Going to daycare
- Diseases that prevent the cilia from working properly
- Changes in altitude (flying or scuba diving)
- Large adenoids
- The weakened immune system from HIV or chemotherapy
What are the symptoms of sinusitis?
The symptoms of acute sinusitis vary in adults. The main symptom is a cold that does not get better, or that gets worse after 5 to 7 days.
The following are the common symptoms of acute sinusitis:
- Bad breath or loss of smell
- Cough, often worse at night
- General feeling of being ill
- Pressure-like pain, pain behind the eyes, toothache
- Tenderness of the face
- Nasal stuffiness
- Nasal discharge
- Sore throat
- Postnasal drip
Symptoms of chronic sinusitis are the same as those of acute sinusitis. However, the symptoms may be mild and last longer than 12 weeks.
The following are the symptoms of sinusitis in children:
- On and off cold or respiratory illness
- High fever
- Darkened nasal discharge that lasts for at least three days
- Nasal discharge with or without a cough.
- Nasal discharge for more than ten days
How is sinusitis diagnosed?
The doctor provider will review the symptoms. The doctor will closely look in the nose for signs of polyps and shines a light against the sinus to look for signs of inflammation. He/she will tap over a sinus area to find the infection.
The doctor may use a nasal endoscopy to look for sinusitis. The doctor may order the following Imaging tests for diagnosis:
- A CT scan of the sinuses to help diagnose sinusitis or view the bones and tissues of the sinuses more closely
- An MRI of the sinuses if there might be a tumor or fungal infection
If the sinusitis does not go away or keeps returning, the following tests may be done:
- Allergy testing
- Blood tests for HIV or other tests for poor immune function
- Ciliary function test
- Nasal culture
- Nasal cytology
- Sweat chloride tests for cystic fibrosis
How is sinusitis treated?
The doctor may recommend the following self-care steps to reduce stuffiness in your sinuses:
- Applying a warm, moist washcloth to your face several times a day.
- Drinking plenty of fluids to thin the mucus.
- Inhaling steam 2 to 4 times per day (for example, while sitting in the bathroom with the shower running).
- Spraying with nasal saline several times per day.
- Using humidifier.
- Using a Neti pot or saline squeeze bottle to flush the sinuses.
The doctor may recommend following steps to help ease sinus pain or pressure:
- Avoid flying when you are congested.
- Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
- Try acetaminophen or ibuprofen.
Mostly, antibiotics are not needed for acute sinusitis. The sinus infections usually go away on their own.
The doctor may prescribe antibiotics if:
- Nasal discharge is not getting better after 2 to 3 weeks in children.
- There is fever higher than 102.2°F (39°C).
- There is a headache or pain in the face
- There is severe swelling around the eyes
Generally, the doctor may treat acute sinusitis for 10 to 14 days, and chronic sinusitis may be treated for 3 to 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
If the infection does not get better, the doctor may do more tests and prescribe other medicines or refer you to an ear, nose, and throat or allergy specialist.
The doctor may also recommend the following other treatments for sinusitis:
- Allergy shots (immunotherapy) to help prevent the disease from returning
- Avoiding allergy triggers
- Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies
The doctor may recommend surgery If your symptoms do not go away after three months of treatment or you have more than 2 or 3 episodes of acute sinusitis each year. Surgery is usually done to enlarge the sinus opening and drain the sinuses.
The doctor may recommend surgery for most fungal sinus infections. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.