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Alternative Names Return to top
Acute sinusitis; Sinus infection; Sinusitis - acuteDefinition Return to top
Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.
See also: Chronic sinusitis
Causes Return to top
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other organisms (they are sterile) and are open, allowing mucus to drain and air to circulate.
When inflamed, the sinuses become blocked with mucus and can become infected. Each year, over 30 million adults and children get sinusitis.
Sinusitis can be acute (lasting anywhere from 2 - 8 weeks) or chronic, with symptoms lingering much longer.
Sinusitis can occur from one of these conditions:
When the sinus openings become blocked and mucus accumulates, this becomes a great breeding ground for bacteria and other organisms.
Sinusitis usually follows respiratory infections, such as colds, or an allergic reaction. Some people never get sinusitis, and others develop sinusitis often.
People more likely to get frequent sinusitis include those with cystic fibrosis and those with immune systems weakened by HIV or chemotherapy.
The following may increase your risk for developing sinusitis:
Cystic fibrosis is one of a number of diseases that prevent the cilia from working properly. Other such diseases that put you at increased risk for sinusitis include Kartagener syndrome and immotile cilia syndrome.
Symptoms Return to top
The classic symptoms of acute sinusitis usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms.
Symptoms include:
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 8 weeks.
Exams and Tests Return to top
Your doctor will test for sinusitis by:
Other tests that might be considered include:
However, these tests are not very sensitive at detecting sinusitis, and are often considered unnecessary.
A CT scan of the sinuses is a much better test to help diagnose sinusitis. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.
If you have chronic or recurrent sinusitis, you may need further lab tests. Tests may include:
Treatment Return to top
Try the following measures to help reduce congestion in your sinuses:
Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them beyond 3 - 5 days can actually worsen nasal congestion.
Also, for sinus pain or pressure:
If self-care measures are not working, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) specialist.
Nasal corticosteroid sprays may be used to decrease swelling, especially if you have swollen structures (such as nasal polyps) or allergies. Avoiding your allergy triggers, taking nasal steroids, antihistamines, and allergy immunotherapy (shots) may help prevent further recurrent disease.
Antibiotics are used to cure the infection causing sinus inflammation.
Acute sinusitis should be treated for 10 - 14 days, while chronic sinusitis should be treated for 3 - 4 weeks.
Surgery to clean and drain the sinuses may also be necessary, especially in patients with recurrent episodes of inflammation despite medical treatment. An ENT specialist, also known as an otolaryngologist, can perform this surgery.
Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent recurrence.
Outlook (Prognosis) Return to top
Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.
Possible Complications Return to top
Although very rare, complications may include:
When to Contact a Medical Professional Return to top
Call your doctor if:
A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.
Prevention Return to top
The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
Other tips for preventing sinusitis:
References Return to top
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for management of acute bacterial sinusitis in children 1-18 years of age. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006 Jul 7. 17 p.
Slavin RG. The diagnosis and management of sinusitis. J Allergy Clin Immunol. Dec 2005; 116(6 Suppl): S13-47.
Update Date: 1/23/2008 Updated by: Alden J. Pearl, MD, Clinical Assistant Professor, Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, Brooklyn, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Page last updated: 09 September 2008 |