Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.
See also: Chronic sinusitis
Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
Sinusitis can be:
Acute sinusitis is usually caused by a bacterial infection in the sinuses that results from an upper respiratory tract infection. Chronic sinusitis refers to long-term swelling and inflammation of the sinuses that may be caused by bacteria or a fungus.
The following may increase your risk or your child's risk of developing sinusitis:
The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. Symptoms include:
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.
Symptoms of sinusitis in children include:
The doctor will examine you or your child for sinusitis by:
Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis.
Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctors who specialize in ear, nose, and throat problems (ENTs).
However, these tests are not very sensitive at detecting sinusitis.
A CT scan of the sinuses may also be used to help diagnose sinusitis or to evaluate the anatomy of the sinuses to determine whether surgery will be beneficial. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.
If you or your child has chronic or recurrent sinusitis, other tests may include:
Try the following measures to help reduce congestion in your sinuses:
Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them for more than 3 - 5 days can actually worsen nasal congestion.
Also, for sinus pain or pressure:
MEDICATIONS AND OTHER TREATMENTS
Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:
Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
At some point, your doctor will consider other prescription medications, further testing, or referral to an ear, nose, and throat (ENT) or allergy specialist.
Other treatments for sinusitis include:
Surgery to clean and drain the sinuses may also be necessary, especially in patients whose symptoms fail to go away after 3 months, despite medical treatment, or in patients who have more than two or three episodes of acute sinusitis each year. An ENT specialist (also known as an otolaryngologist) can perform this surgery.
Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.
Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.
Although very rare, complications may include:
Call your doctor if:
A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.
The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
Other tips for preventing sinusitis:
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for management of acute bacterial sinusitis in children 1 to 18 years of age. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006.
Slavin RG, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005;116:S13-S47.
Rosenfeld RM, Singer M, Jones S. Systematic review of antimicrobial therapy in patients with acute rhinosinusitis. Otolaryngol Head Neck Surg. 2007;137:S32-S45.
Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, et al. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2007;137:S1-S31.