Sinusitis is an inflammation or infection of the linings of the sinuses - the cavities in the bones behind the eyes, nose, and forehead. There are three major types of sinusitis: acute sinusitis, which involves less than 3 weeks of symptomssubacute sinusitis, with symptoms lasting 3 weeks to 3 monthschronic sinusitis, in which symptoms last longer than 3 months
There are four pairs of sinuses that connect to the nose and throat. The sinuses are normally filled with air. They moisten, cleanse, and warm the air after it leaves the nose on the way to the lungs. The normal nose is created to be a wonderful filter. It removes 80% of all tiny particles.
Acute allergic sinusitis occurs when the lining of the nose and sinuses becomes inflamed. Common causes include pollens, animal dander, and other allergens. These allergens set off an inflammatory response. Histamine and other chemicals are released, causing the symptoms of acute allergic sinusitis.
Viral sinusitis can occur together with an upper respiratory infection (URI). Viruses attack the lining of the sinuses and cause swelling of the nasal tissues, which leads to symptoms.
Bacterial sinusitis can follow a viral infection if bacteria grow inside the sinuses. About 5 out of every 1,000 viral URIs are complicated by a bacterial sinus infection. Bacterial forms of sinusitis also occur when the drainage opening is blocked by swelling or narrowing. Then the normal bacteria in the sinus and nasal tracts overgrow and cause an infection.
Cold air sinusitis produces symptoms when the person is exposed to cold air.
Aspirin sensitivity sinusitis may occur in some individuals when they take medicines containing aspirin.
Symptoms of sinusitis vary, depending on the cause and type of sinusitis.
Acute allergic sinusitis may cause: clear, watery discharge from both sides of the nosemild coughingnasal and ear itchingnasal congestionsneezingtearing and eye itching
Viral sinusitis can cause the following symptoms: coughingfacial painfever and chillsmuscle aches and joint painnasal congestionnasal dischargesore throat and hoarseness
Viral sinusitis usually resolves spontaneously within two or three weeks. It is most common in the fall, winter, and early spring.
Bacterial sinusitis in adults can produce the following symptoms: discolored nasal drainagefacial painheadachenasal congestion
Bacterial sinusitis in children may cause: coughingfacial painfacial swellingfevergreen to yellow nasal dischargenasal congestion
Bacterial sinusitis may be acute, subacute, or chronic. Its onset may be sudden or gradual. Some patients describe it as a "cold that won't go away".
Cold air sinusitis may cause these symptoms: clear nasal dischargefacial pressurenasal congestionsneezing
Dry air sinusitis is often seen in the winter months and may cause: nasal congestionyellow to slightly bloody crusting, especially in the front part of the nose
Aspirin sensitivity sinusitis may cause: long-term facial painheadachesloss of smellnasal polyps, which are growths that protrude from the mucous membranevery thick, white or yellow nasal discharge
Sinusitis may be caused by a virus, bacteria, allergen, or other factors as outlined above. People with immunodeficiency disorders are at higher risk for some types of sinusitis.
Many cases of sinusitis can be avoided by preventing an upper respiratory infection. Avoiding crowded places and infected people can lessen the risk of catching a virus. Influenza or flu vaccination can help prevent infection by the influenza virus. Careful hand washing and disposal of tissues can help prevent the spread of sinusitis. Individuals should follow the healthcare provider's recommendation for good control of nasal allergies.
Diagnosis of sinusitis begins with a medical history and physical exam. The healthcare provider may order additional tests, such as: blood and urine testsallergy testingcultures of nasal secretionsCT scan
If sinusitis is untreated, the individual may have serious long-term effects, including: infection of the eye socketmeningitis, or infection of the brain liningschronic facial painloss of smellchronic headaches
The viruses and bacteria involved in those forms of sinusitis are contagious from person to person. However, if infected, a close contact of a person with sinusitis might develop sinusitis, another respiratory illness, or no symptoms at all.
Treatment varies, depending on the cause and type of sinusitis. Some common treatments include: avoiding triggers, such as cold air or allergenssaline nasal spray or rinseswarm compresses on the face humidifiers (to keep room humidity at about 40% relative humidity)increased oral fluidspain medicine such as ibuprofen (i.e., Advil, Motrin), aspirin or acetaminophen (i.e., Tylenol)oral decongestant medicines such as pseudoephedrine and phenylephrinedecongestant nasal sprays such as oxymetazoline (i.e., Afrin) or phenylephrine (i.e., Neo-Synephrine). However, these sprays should not be use for more than three to five days prescription non-steroid nasal sprays such as azelastine (i.e., Astelin), cromolyn (i.e., NasalCrom), ipratropium (i.e., Atrovent Nasal) or any number of nasal steroid sprays.prescription steroid nasal sprays such as beclomethasoneq (i.e., Beconase), fluticasone (i.e., Flonase), flunisolide (i.e., Nasarel), triamcinolone (i.e., Nasacort), mometasone (i.e., Nasonex) or budesonide (i.e., Rhinocort)oral corticosteroids such as prednisoneantibiotics are used much less frequently than they used to be. The reason is that a number of recent randomized controlled trials and meta-analyses (research that combines a number of studies together) have show that antibiotics have little advantage over no treatment - with most patients improving without antibiotics.
Side effects depend on the medicines used. Brief use of topical decongestants has few side effects. Long-term use of topical decongestants (more than 3-5 days) can cause progressive inflammation in the nose.
Most cases of sinusitis go away on their own or with treatment. Some individuals may develop chronic sinusitis.
Any new or worsening symptoms should be reported to the healthcare provider.
