Sinusitis is inflammation of the sinus cavities. The sinus cavities are air-filled spaces in the skull. It is usually associated with infection.
Sinusitis is called acute if it lasts for less than 4 weeks, subacute if it lasts 4-12 weeks, and chronic if symptoms last for more than 3 months. You may have recurrent sinusitis if you have repeated bouts of acute sinusitis.
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Infectious sinusitis is caused by a viral, bacterial, or (rarely) fungal infection of fluid in the sinus cavities. Infections are usually associated with acute sinusitis more than chronic.
Factors that may increase your chance of sinusitis include:
- Recent viral infection
- Smoking or exposure to second-hand smoke
- Other sources of indoor or outdoor air pollution
- Allergies or asthma
- Abnormalities of the facial bones, sinuses, 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) and immotile cilia syndrome
- Wegener granulomatosis—rare disease that causes blood vessel walls to become inflamed
- HIV infection and other disorders of the immune system
- Head injury or a medical condition requiring a tube to be inserted into the nose
- Cocaine and other drugs inhaled through the nose
Sinusitis may cause:
- Facial congestion or fullness
- Facial pain or pressure that increases when you bend over or press on the area
- Cough, which is often worse at night
- Nasal congestion not responding well to either decongestants or antihistamines
- Runny nose or postnasal drip
- Thick, yellow, or green mucus
- Bad breath
- Ear pain, pressure, or fullness
- Dental pain
- Initial improvement with sudden worsening of symptoms over the course of a few weeks
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 light up
- CT scan or x-ray of the sinuses to look for fluid in the sinus
- Endoscopic examination of the sinuses—threading a tiny, lighted tube into the nasal cavities to view the sinus opening
- Removing sinus fluid through a needle for testing (rare)
You have may acute sinusitis when the following occurs:
- History of 10 or more days of colored mucous, or visibly infected mucus
- Tenderness over the sinuses
- Difficulty smelling
Most sinus infections are caused by a virus and will pass on their own in 7-10 days. Home care and medications can help manage symptoms.
Infections that last longer or keep coming back may need more care.
To help reduce your chance of sinusitis:
- 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
- Stick with your allergy treatment plan
- If you get a cold, drink lots of fluids and use a decongestant.
- Use sinus washes as directed.
- Blow your nose gently, while pressing one nostril closed.
- If you must travel by air, 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 HEPA filters for your furnace and vacuum cleaner to remove allergens from the air.
- Avoid cigarette smoke.