What is sinusitis?

Sinusitis or sinus infection is a very common condition and affects up to 35 million Americans. The sinuses are air filled cavities in the forehead and cheekbones and their function is to produce mucus to lubricate the nasal passages. The sinuses are connected to the nasal pasages and throat by small channels through which the mucus flows. These are prone to becoming obstructed leading to a blocked sinuses. This can cause an increase in sinus pressure and sinus congestion, due to a build up of mucus secretions which can cause pain over the affected sinus.

The lining of the sinuses can also become inflamed and this is called a sinusitis, which is usually caused by an infection in the sinuses. The symptoms that are usually associated with sinus infections are pain and tenderness across the forehead or in the cheekbones, headache, nasal congestion, blocked nose, loss of smell, mucus discharge from the nose and a high temperature. Sinusitis can be a short lasting condition, typically a week or so in acute sinusitis or it can last for months in chronic sinusitis.

What causes sinusitis?

Sinusitis is usually caused by viral infections, for example a cold or flu, to begin with, as these cause increased mucus production by the sinuses. This is usually watery and clear and will often resolve itself after a few days. If bacteria take hold on top of the viral infection then the symptoms become more severe, last longer and the mucus becomes yellow or green. There are a number of other less common causes of sinusitis including allergic rhinitis (an allergy of the nose), blockage of the sinus canals by nasal polyps or objects pushed into the nose in children, asthma and some immunodeficiency disorders. Sometimes dental infections can spread to the sinuses from the teeth and rare tumours of the nasal passages can also be a causal factor.

Treatment for sinusitis

In acute sinusitis usually all that is necessary is some painkillers such as ibuprofen and paracetamol and decongestant nasal sprays or drops, which reduce the mucus secretions from the sinuses and nose and ease the sinus pressure and pain. These should only be used for 5-7 days as they can cause a rebound aftewards which can make the symptoms worse. They can also have side effects so should always be discussed with your pharmacist or doctor. Acute sinusitis usually resolves within a week to 10 days and usually causes no long term problems. Antibiotic treatment for acute sinusitis is usually only necessary if it lasts longer than about a week and there is continuing thick green or yellow nasal discharge. Complications of sinusitis can occur, and though rare, can be serious and usually arise from infection spreading into the eye, bones, blood or even the brain. Signs of complications arising include being generally very unwell and swelling or redness around the eyelid or cheek. Should these symptoms arise you should see a doctor immediately.

In chronic sinusitis or frequently recurring sinusitis it is advisable to see a doctor to consider some tests to find out if there is some underlying cause for the sinusitis. Your doctor would examine you for any signs of nasal polyps or other blockages to your sinuses and may consider arranging some x rays of your sinuses. These can sometimes demonstrate fluid levels if there is a long term mucus collection in you sinuses or thickening of the lining of the sinuses indicating chronic inflammation there. Your doctor may advise or prescribe further sinus medications for a longer period such as nasal sprays or tablets. If your symptoms continue to persist then your doctor may refer you to a specialist to examine your nose and sinuses further. This is usually by use of a small fibre optic telescope (endoscope) which can look into your nasal passages and sinuses to reveal any potential underlying causes for your sinus problems. In severe and difficult to treat sinustis sometimes an operation is necessary to treat it effectively. A CT scan is sometimes required to see if an operation is likely to be beneficial and if it is, then it can often be done using an endoscope without the need for any cuts. Obviously this treatment is complex and would involve detailed discussions with a specialist doctor.

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This article is for general information purposes only and does not constitue medical advice. If you are concerned about your symptoms you should always consult with your doctor.