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Sinusitis
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Overview
"Sinusitis" simply means your
sinuses are inflamed? Red and swollen because of an infection or another
problem. There are several types of sinusitis. Health experts usually identify
them as follows:
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Overview
-- Acute, which lasts up to 4 weeks
-- Subacute, which lasts 4 to 12 weeks
-- Chronic, which lasts more than 12 weeks and
can continue for months or even years
-- Recurrent, with several attacks within a
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Overview
year
In 2009, the Centers for Disease Control and Prevention
reported that nearly 31 million adults were diagnosed with sinusitis. Women
were almost twice as likely as men to receive the diagnosis, and there were
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Overview
more cases in the southern United States than elsewhere in the country.
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Symptoms
One of the most common symptoms of any type
of sinusitis is pain, and the location depends on which sinus is affected.
If you have pain in your forehead, the
problem lies in your frontal sinuses.
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Symptoms
Pain in your upper jaw and teeth, with
tender cheeks, may mean your maxillary sinuses are involved.
Experiencing pain between your eyes,
sometimes with swelling of the eyelids and tissues around your eyes, and
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Symptoms
tenderness when you touch the sides of your nose may mean sinusitis has
developed in your ethmoid sinuses.
Pain in your neck, with earaches, and deep
achiness at the top of your head could be a sign that your sphenoid sinuses are
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Symptoms
involved (though these sinuses are affected less often).
Most people with sinusitis have pain or
tenderness in several places, and their symptoms usually do not clearly
indicate which sinuses are inflamed. Pain is not as common in chronic sinusitis
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Symptoms
as it is in acute sinusitis.
In addition to the pain, people who have
sinusitis (acute or chronic) often have thick nasal secretions that can be
white, yellowish, greenish, or blood-tinged. Sometimes these secretions drain
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Symptoms
in the back of the throat and are difficult to clear. This is referred to as
“post-nasal drip.” Also, cases of acute and chronic sinusitis are usually
accompanied by a stuffy nose, as well as by a general feeling of fullness over
the entire face.
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Symptoms
Less common symptoms of sinusitis (acute or
chronic) can include the following:
-- Tiredness
-- Decreased sense of smell
-- Cough that may be worse at night
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Symptoms
-- Sore throat
-- Bad breath
-- Fever
On very rare occasions, acute sinusitis can
result in brain infection and other serious complications.
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Symptoms
Because your nose can get stuffy or
congested when you have a condition like the common cold, you may confuse
simple nasal congestion with sinusitis. A cold usually lasts about 7 to 14 days
and goes away without treatment. Acute sinusitis often lasts longer and
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Symptoms
typically causes more symptoms than a cold.
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Causes
The paranasal sinuses, like the inside of
your nose, are lined with a thin layer of tissue called the mucous membrane,
which produces mucus. This mucus flows out through openings of the paranasal
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Causes
sinuses and into the nose. When these openings become blocked, your sinuses are
affected.
Anything that causes swelling in the nose
can block the openings between your paranasal sinuses and your nose, including
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Causes
a cold, an allergic reaction such as hay fever, or a reaction to some chemical
to which you've been exposed. The blockage causes air and mucus to become
trapped within the sinuses. This may cause pain and thickened mucus.
The pain of a sinus attack arises because
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Causes
the trapped air and mucus put pressure on the mucous membrane of the sinuses
and the bony wall behind it. Also, when a swollen membrane at the opening of a
paranasal sinus prevents air from entering into the sinuses, it can create a
vacuum that causes pain.
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Causes
Mucus thickens because it loses its water
content as it stays trapped inside the sinuses for a long time. In addition,
inflammation leads to extra materials being secreted into the mucus, causing
thickening.
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Diagnosis
Your healthcare professional usually can
diagnose acute sinusitis by noting your symptoms and examining your nose and
face. If your symptoms do not clearly indicate that you have sinusitis or if
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Diagnosis
they persist for a long time and do not get better with treatment, your
healthcare professional may order a CT (computerized tomography) scan (a form
of X-ray that shows some soft-tissue and other structures that cannot be seen
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Diagnosis
in conventional X-rays) to confirm that you have sinusitis.
Other laboratory tests your healthcare
professional may use to check for possible causes of chronic rhinosinusitis
include the following:
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Diagnosis
-- Blood tests to rule out conditions, such as
an immune deficiency disorder, that are associated with sinusitis
-- A sweat test or a blood test to rule out
cystic fibrosis
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Diagnosis
-- Tests on the material inside your sinuses
to detect bacterial or fungal infection
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Treatment
After diagnosing sinusitis and identifying
a possible cause, your healthcare professional can suggest various treatments.
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Treatment**Acute sinusitis**
If you have acute sinusitis, your
healthcare professional may recommend the following:
-- Antibiotics to control a bacterial
infection, if present
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Treatment**Acute sinusitis**
-- Pain relievers to reduce any pain
-- Decongestants (medicines that shrink the
swollen membranes in the nose and make it easier to breathe)
Even if you have acute sinusitis, your
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Treatment**Acute sinusitis**
healthcare professional may choose not to use an antibiotic because many cases
of acute sinusitis will end on their own. However, if you do not feel better
after a few days, you should contact your healthcare professional again.
Follow your healthcare professional's
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Treatment**Acute sinusitis**
instruction on how to use over-the-counter or prescription decongestant nose
drops and sprays. You should use these medicines for only a few days, as longer
term use can lead to even more congestion and swelling of your nasal passages.
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Treatment**Acute sinusitis**
If you suffer from nasal allergies, such as
hay fever, along with sinusitis, your healthcare professional may recommend
medicine to control your allergies. This may include a nasal steroid spray that
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Treatment**Acute sinusitis**
reduces the swelling around the sinus passages and allows the sinuses to drain.
If you have asthma and then get sinusitis,
your asthma may worsen. You should contact your healthcare professional, who
may change your asthma treatment.
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Treatment**Chronic rhinosinusitis**
Healthcare professionals often find it
difficult to treat chronic rhinosinusitis successfully. They have two options
to offer patients: medicine and surgery.
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Treatment**Medicine**
Nasal steroid sprays are helpful for many
people, but most people still do not get full relief of symptoms with these
medicines.
A long course of antibiotics is
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Treatment**Medicine**
occasionally recommended by physicians, but results from clinical research do
not support this kind of antibiotic use.
Saline (saltwater) washes or saline nasal
sprays can be helpful in chronic rhinosinusitis because they remove thick
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Treatment**Medicine**
secretions and allow the sinuses to drain.
Oral steroids, such as prednisone, may be
prescribed for severe chronic rhinosinusitis. However, oral steroids are
powerful medicines with significant side effects, and these medicines typically
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Treatment**Medicine**
are prescribed when other medicines have failed.
Research is needed to develop new, more
effective treatments.
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Treatment**Surgery**
When medicine fails, surgery may be the
only alternative for treating chronic rhinosinusitis. The goal of surgery is to
improve sinus drainage and reduce blockage of the nasal passages. Nasal surgery
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Treatment**Surgery**
usually is performed to accomplish the following:
-- Enlarge the natural openings of the sinuses
-- Remove nasal polyps
-- Correct significant structural problems
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Treatment**Surgery**
inside the nose and the sinuses if they contribute to sinus obstruction
Although most people have fewer symptoms
and a better quality of life after surgery, problems can reoccur, sometimes
even after a short period of time.
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Treatment**Surgery**
In children, problems can sometimes be
eliminated by removing the adenoids. These gland-like tissues, located high in
the throat behind and above the roof of the mouth, can obstruct the nasal
passages.
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Prevention
There are no methods that have been
scientifically proven to prevent acute or chronic sinusitis. Your healthcare
professional may recommend the following measures that can help:
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Prevention
-- Keep your nose as moist as possible with
frequent use of saline sprays or washes.
-- Avoid very dry indoor environments and use
a humidifier, if necessary. Be aware, however, that a humid environment also
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Prevention
may increase the amount of mold, dust mite, or cockroach allergens in your
home; this is important only if you are allergic to any of those organisms.
-- Avoid exposure to irritants such as
cigarette and cigar smoke or strong odors from chemicals.
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Prevention
-- Avoid exposure to substances to which you
are allergic.
-- If you haven’t been tested for allergies
and you are getting frequent sinus infections, ask your healthcare professional
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Prevention
to give you an allergy evaluation or refer you to an allergy specialist.
-- Avoid long periods of swimming in pools
treated with chlorine, which can irritate the lining of the nose and sinuses.
-- Avoid water diving, which forces water into
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Prevention
the sinuses from the nasal passages.
Air travel may pose a problem if you suffer
from acute or chronic sinusitis. When air pressure in a plane is reduced,
pressure can build up in your head, blocking your sinuses or the eustachian
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Prevention
tubes (the airways between the middle ear and the back of the throat that
equalize air pressure on either side of the eardrum). As a result, you might
feel discomfort in your sinuses or middle ear during the plane’s ascent or
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Prevention
descent. Some health experts recommend using decongestant nose drops or sprays
before a flight to avoid this problem.
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