Definition

Sinusitis is inflammation of the sinus cavities. The sinus cavities are air-filled spaces in the skull. It may be:

• Acute—lasts for less than 4 weeks
• Subacute —lasts 4 to 12 weeks
• Chronic—if symptoms last for more than 3 months
• Recurrent—if you have repeated bouts of acute sinusitis

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Causes

Acute sinusitis is often caused by an infection. It may be viral, bacterial, or fungal (rare). Chronic sinusitis may happen in people who are at higher risk of infection. It may also be due to irritation from contaminants in the air like smoking, pollution, or allergens.

Risk Factors

Factors that may increase the 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
• Head injury or a medical condition requiring a tube to be inserted into the nose
• Cocaine and other drugs inhaled through the nose

Problems with structures around the face may increase the risk of sinusitis. Examples include:

• Deviated septum
• Nasal polyps
• Cleft palate
• Large adenoids

Chronic illnesses the increase risk of sinusitis include:

• HIV infection and other disorders of the immune system
• Diabetes
• Cystic fibrosis
• Kartagener syndrome (a chronic lung disease) and immotile cilia syndrome
• Granulomatosis with polyangiitis—rare disease that causes blood vessel walls to become inflamed
• Sarcoidosis

Symptoms

Sinusitis may cause:

• Facial congestion or fullness
• Facial pain or pressure that increases when you bend over or press on the area
• Headache
• 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
• Fever
• Fatigue
• Dental pain
• Symptoms seem to improve then suddenly get worse over a few weeks

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor can diagnose sinusitis based on its symptoms and exam. More tests may be done if sinusitis is not responding to treatment or keeps coming back. Tests may include:

• 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

Treatment

Most sinus infections will pass on their own in 7 to 10 days. Home care and medicine can help to manage symptoms.

Infections that last longer or keep coming back may need more care.

Prevention

To help reduce the chance of sinusitis:

• Learn how to treat allergies.
  • Avoid allergens when possible
  • Stick with allergy treatment plan
• Drink lots of fluids when a cold is present.
• Use sinus washes as directed.
• Blow nose gently.
• Use a nasal spray decongestant to decrease inflammation while traveling by air. Take it prior to takeoff and landing.
• Use a humidifier to manage colds or allergies.
• Use HEPA filters for furnace and vacuum cleaner.
• Avoid cigarette smoke.