Sinusitis

What is sinusitis?

Sinusitis is swollen or 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 swell or become infected. The passageways from the sinuses to the nose are very narrow. Swelling of the sinus linings causes them to produce too much mucus. The swelling and the extra mucus may block the passageways. This leads to pressure changes in the sinuses that can be painful.

A number of different irritants can cause swelling and sinusitis. Sinusitis often occurs after a cold, but not always. Bacteria, viruses, allergies, and even fungus can cause sinusitis.

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
• tenderness above, behind, 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 health care 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 health care 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.

If you have chronic or repeated sinus infections, allergies may be the cause. Your health care 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, weeks, or months.

How can I take care of myself?

• Follow your health care 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 decongestants as directed on the label or by your provider. Generally, nasal spray decongestants should not be used for more than 3 days. After 3 days they may cause your symptoms to get worse. Ask your health care provider if it is OK to use them longer.
• Get plenty of rest and drink more fluids.
• Put warm compresses on painful areas.
• Take antibiotics as prescribed. Use all of the medicine, even after you feel better.
• See your health care provider if the pain lasts for several days.
• If the sinus areas above or below your eyes are swollen or bulging, see your health care provider right away.

How can I help prevent sinusitis?

• Treat your colds and allergies promptly. Use decongestants as soon as you start having symptoms.
• Do not 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 (otolaryngologist). The specialist will check for polyps or a deformed bone that may be blocking your sinuses.