Definition

Sinusitis is inflammation of the sinus cavities. It is 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.

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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    TOP

These factors increase your chance of developing sinusitis. Tell your doctor if you have any of these risk factors:

• Recent viral infection
• Smoking or exposure to second-hand smoke
• Other sources of indoor or outdoor air pollution
• Allergies, particularly hay fever
• Abnormalities of the facial bones or nasal passages, such as:
  • Deviated septum
  • Nasal polyps
  • Cleft palate
  • Large adenoids
• Certain chronic illnesses, including:
  • Cystic fibrosis
  • Kartagener's syndrome (a chronic lung disease)
  • Wegener's granulomatosis (rare disease that causes blood vessel walls to become inflamed)
  • Asthma
  • Sarcoidosis
• HIV infection
• Diabetes
• Head injury or a medical condition requiring a tube to be inserted into the nose

Symptoms    TOP

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    TOP

Your doctor will ask about your symptoms and medical history. A physical exam will be done. 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
• Removing sinus fluid through a needle for testing (rare)
• Endoscopic examination of the sinuses—threading a tiny, lighted tube into the nasal cavities to view the sinus opening

You have acute sinusitis when the following occurs:

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

Treatment    TOP

Prevention    TOP

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 takeoff and landing.
• Use a humidifier when you have a cold, allergic symptoms, or sinusitis.
• Use High-Efficiency Particulate Air (HEPA) filters for your furnace and vacuum cleaner to remove allergens from the air.
• Avoid cigarette smoke.