Sinusitis

What is sinusitis?

Sinusitis is swollen, infected linings of the sinuses. The sinuses are hollow spaces in the bones of your face and skull. They connect with the nose through small openings. Like the nose, their linings make mucus.

How does it occur?

Sinusitis occurs when the sinus linings become infected. The passageways from the sinuses to the nose are very narrow. Swelling and mucus may block the passageways. This leads to pressure changes in the sinuses that can be painful.

A number of things can cause swelling and sinusitis. Most often it's allergens (things that cause allergies, like pollen and mold) and viruses, such as viruses that cause the common cold. Whether the cause is allergies or a virus, the sinus linings can swell. When swelling causes the sinus passageway to swell shut, bacteria, viruses, and even fungus can be trapped in the sinuses and cause a sinus infection.

If your nasal bones have been injured or are deformed, causing partial blockage of the sinus openings, you are more likely to get sinusitis.

What are the symptoms?

Symptoms include:

• feeling of fullness or pressure in your head
• a headache that is most painful when you first wake up in the morning or when you bend your head down or forward
• pain above or below your eyes
• aching in the upper jaw and teeth
• runny or stuffy nose
• cough, especially at night
• fluid draining down the back of your throat (postnasal drainage)
• sore throat in the morning or evening.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and will examine you. You may have an X-ray to look for swelling, fluid, or small benign growths (polyps) in the sinuses.

How is it treated?

Decongestants may help. They may be nonprescription or prescription. They are available as liquids, pills, and nose sprays.

Your healthcare provider may prescribe an antibiotic. In some cases you may need to take decongestants and antibiotics for several weeks.

You may need nonprescription medicine for pain, such as acetaminophen or ibuprofen. Children under 18 years of age should not take aspirin or products containing salicylate (such as Pepto-Bismol) because of the risk of Reye's syndrome unless recommended by a healthcare provider.

If you have chronic or repeated sinus infections, allergies may be the cause. Your healthcare provider may prescribe antihistamine tablets or prescription nasal sprays (steroids or cromolyn) to treat the allergies.

If you have chronic, severe sinusitis that does not respond to treatment with medicines, surgery may be done. The surgeon can create an extra or enlarged passageway in the wall of the sinus cavity. This allows the sinuses to drain more easily through the nasal passages. This should help them stay free of infection.

How long will the effects last?

Symptoms may improve gradually over 3 to 10 days. Depending on what caused the sinusitis and how severe it is, it may last for days or weeks.

How can I take care of myself?

• Follow your healthcare provider's instructions.
• Avoid tobacco smoke.
• If you have allergies, take care to avoid the things you are allergic to, such as animal dander.
• Add moisture to the air with a humidifier or a vaporizer, unless you have mold allergy (mold may grow in your vaporizer).
• Inhale steam from a basin of hot water or shower to open your sinuses and relieve pain.
• Use saline nasal sprays to help wash out nasal passages and clear some mucus from the airways.
• Use decongestants as directed on the label or by your provider.
• If you are using a nonprescription nasal-spray decongestant, generally you should not use it for more than 3 days. After 3 days it may cause your symptoms to get worse. Ask your healthcare provider if it is OK for you to use a nasal spray decongestant longer than this.
• Get plenty of rest.
• Drink more fluids to keep the mucus as moist and liquid as possible to help draining of your sinuses.
• Put warm compresses on painful areas.
• Take antibiotics as prescribed. Use all of the medicine, even after you feel better. Some sinus infections require 2 to 4 weeks of antibiotic treatment.
• See your healthcare provider if the pain lasts for several days or gets worse.
• If the sinus areas above or below your eyes are swollen or bulging, see your healthcare provider right away. This symptom may mean that the infection is spreading. A spreading infection can affect other parts of your body--even the brain--and needs to be treated promptly.

How can I help prevent sinusitis?

• Treat your colds and allergies promptly. Use decongestants as soon as you start having symptoms.
• Do not smoke and stay away from secondhand smoke.
• Drink lots of fluids to keep the mucus thin.
• Humidify your home if the air is particularly dry.
• If you have sinus infections often, consider having allergy tests.
• If sinusitis continues to be a problem despite treatment, you might need an exam by an ear, nose, and throat doctor (called an ENT or otolaryngologist). The specialist will check for polyps or a deformed bone that may be blocking your sinuses.