(Sinus Infection; Acute Sinusitis; Chronic Sinusitis)
DefinitionSinusitis is inflammation of the sinus cavities. It is usually associated with infection. The sinus cavities are air-filled spaces in the skull.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.
|Copyright © Nucleus Medical Media, Inc.|
CausesInfectious sinusitis is caused by bacterial, viral, or rarely fungal infection of fluid in the sinus cavities.
Risk FactorsFactors that may increase your chance of sinusitis include:
- Recent viral infection
- Smoking or exposure to second-hand smoke
- Other sources of indoor or outdoor air pollution
- Allergies or asthma
- Abnormalities of the facial bones, sinuses, or nasal passages, such as:
- Certain chronic illnesses, including:
- HIV infection and other disorders of the immune system
- Head injury or a medical condition requiring a tube to be inserted into the nose
- Cocaine and other drugs inhaled through the nose
SymptomsSinusitis may cause:
- Facial congestion or fullness
- Facial pain or pressure that increases when you bend over or press on the area
- Cough, which is often worse at night
- Nasal congestion not responding well to either decongestants or antihistamines
- Runny nose or postnasal drip
- Thick, yellow, or green mucus
- Bad breath
- Ear pain, pressure, or fullness
- Dental pain
DiagnosisYour 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 up
- CT 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 opening
- Removing sinus fluid through a needle for testing (rare)
- History of 10 or more days of colored mucous, or visibly infected mucus
- Tenderness over the sinuses
- Difficulty 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.
SurgerySurgery 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)
PreventionTo 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.
American Academy of Otolaryngology—Head and Neck Surgery
National Institute of Allergy and Infectious Diseases
Allergy Asthma Information Association
Calgary Allergy Network
Acute sinusitis in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated August 4, 2014. Accessed September 29, 2014.
Acute sinusitis in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated February 7, 2014. Accessed September 29, 2014.
Allergic rhinitis, sinusitis, and rhinosinusitis. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/allergic-rhinitis-sinusitis-and-rhinosinusitis. Accessed September 29, 2014.
Aring AM, Chan MM. Acute rhinosinusitis in adults. Am Fam Physician. 2011;83(9):1057-1063.
Chronic rhinosinusitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.Updated April 14, 2014. Accessed September 29, 2014.
Mandell GL, Douglas RG, et al. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA: Churchill Livingstone, Inc; 2000.
Okuyemi KS, Tsue TT. Radiologic imaging in the management of sinusitis. Am Fam Physician. 2002;66:1882-1886.
Rakel RE, Bope ET. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Sinusitis. National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH) website. Available at: http://www.niaid.nih.gov/topics/sinusitis/Pages/index.aspx. Accessed September 29, 2014.
Stewart AE, Vaughan WC. Balloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010;10(3):181-187.
1/10/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Williamson IG, Rumsby K, Benge S, et al. Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: a randomized controlled trial. JAMA. 2007;298:2487-2496.
12/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Zalmanovici A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database Syst Rev. 2009;(4):CD005149.
- Reviewer: Michael Woods, MD
- Review Date: 09/2014
- Update Date: 09/30/2014
Obesity is associated with a complex combination of factors but the earliest feeding habits may play a role in childhood obesity. A review of studies across several countries found that breastfeeding may decrease the risk of obesity in childhood.
Research Review Finds Little Support for Nearly Half of Medical Talk Show Recommendations
Strength Training, Tai Chi, and Aerobics May Improve Balance in People With Knee Osteoarthritis