Sinusitis
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Sinusitis

(Sinus Infection; Acute Sinusitis; Chronic Sinusitis)

En Español (Spanish Version)More InDepth Information on This Condition

Definition

Sinusitis is inflammation of the sinus cavities 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

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors for sinusitis include:

Symptoms

Symptoms of sinusitis may include:

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

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. 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 of the sinuses—a type of x-ray that uses a computer to make pictures of structures inside the head
  • 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)

You have acute sinusitis when the following occur:

  • History of 10 or more days of colored mucus
  • Tenderness over the sinuses
  • Visible mucus in the nose

Treatment

Moisturization

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.

Steam Treatments

Keep a humidifier running in your bedroom. Fill a bowl with steaming water every couple of hours, and make a steam tent with a towel over your head. This will let you breathe in the steam.

Decongestants

Use either decongestant pills or nasal sprays to shrink nasal passages. Don't use nasal sprays for longer than 3-4 days in a row. If you need longer treatment, your doctor may prescribe intranasal corticosteroid medications, especially if you have had recurrent sinus problems.

Antihistamines

Allergy medications called antihistamines may help sinusitis symptoms if they are caused by allergies. But they may also dry out the nasal mucosa.

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 Pain Medication

You can use acetaminophen , ibuprofen , or aspirin to treat sinus pain.

Note : Aspirin is not recommended for children with a current or recent viral infection. Check with your child's doctor before giving your child aspirin.

Guaifenesin-Containing Cough Medicines

These can help you cough up secretions.

Surgical Procedures

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

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).
  • 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 take-off 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.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org/

National Institute of Allergy and Infectious Diseases
http://www.niaid.nih.gov/

CANADIAN RESOURCES:

Allergy Asthma Information Association
http://aaia.ca/

Calgary Allergy Network
http://www.calgaryallergy.ca/

References:

Fact sheet: allergic rhinitis, sinusitis, and rhinosinusitis American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/rhinitis.cfm . Accessed June 22, 2008.

Mandell GL, Douglas RG, Bennett JE. 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.

Scheid DC, Hamm RM. Acute bacterial rhinosinusitis in adults. Am Fam Physician . 2004;70:1685-1692:1697-1704.

Sinus infection (sinusitis). National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH) website. Available at: http://www3.niaid.nih.gov/healthscience/healthtopics/sinus/overview.htm . Accessed June 22, 2008.

Sinusitis. EBSCO DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=116738 . Accessed November 10, 2007.

*1/10/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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.



Last reviewed November 2007 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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