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(Sinus Infection; Acute Sinusitis; Chronic Sinusitis)

Sinusitis – Definition

Sinusitis is inflammation of the sinus cavities usually associated with infection. The sinus cavities are air-filled spaces in the skull.

Acute sinusitis lasts for less than three weeks. Chronic sinusitis is diagnosed when symptoms last for at least three months. You may have recurrent sinusitis if you have repeated bouts of acute sinusitis.

Sinusitis – Causes

Infectious sinusitis is caused by bacterial or fungal infection of the sinus cavities. The most common organisms to cause acute sinusitis include:

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis

Sinusitis – Risk Factors

These factors increase your chance of developing sinusitis. Tell your doctor if you have any of these risk factors:

  • Recent viral infection
  • Smoking or exposure to second-hand smoke
  • Other sources of indoor or outdoor air pollution
  • Allergies, particularly hay fever
  • Abnormalities of the facial bones 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)
    • Wegener’s granulomatosis (rare disease that causes blood vessel walls to become inflamed)
    • Asthma
    • Sarcoidosis
  • HIV infection
  • Diabetes
  • Head injury or a medical condition requiring a tube to be inserted into the nose

Sinusitis – Symptoms

Symptoms of sinusitis may include:

  • Nasal congestion not responding well to either decongestants or antihistamines
  • Runny nose or postnasal drip
  • Thick, yellow, or green mucus
  • Cough, often worse at night
  • Ear pain, pressure, or fullness
  • Headache
  • Fever
  • Dental pain
  • Facial pain or pressure that increases when you bend over or press on the area
  • Facial congestion or fullness
  • Bad breath
  • Fatigue

Sinusitis – Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. 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 are illuminated
  • CT scan of the sinuses — a type of x-ray that uses a computer to make pictures of structures inside the head
  • Removing sinus fluid through a needle for testing (rare)
  • Endoscopic examination of the sinuses — threading a tiny, lighted tube into the nasal cavities to view the sinus opening

You have acute sinusitis when the following occur:

  • History of 10 or more days of colored mucus
  • Tenderness over the sinuses
  • Visible mucus in the nose

Sinusitis – Treatment

Home Care

  • Moisturizing — Drinking lots of fluids may keep your nasal secretions thin. This will avoid plugging up your nasal passages and sinuses. Salt water nose sprays or irrigation may also loosen nasal secretions.
  • Using steam treatments — Keep a humidifier running in your bedroom. Fill a bowl with steaming water every couple of hours, and make a steam tent with a towel over your head. This will let you breathe in the steam.


  • Decongestants — Use either decongestant pills or nasal sprays to shrink nasal passages. Do not use nasal sprays for longer than 3-4 days in a row.
  • Intranasal corticosteroids — These are inhaled directly into your nose through a nasal spray. Corticosteroids may help relieve congestion by decreasing swelling in the lining of the nose.
  • Antihistamines — Allergy medicines called antihistamines may help sinusitis symptoms if they are caused by allergies. But they may also dry out the nasal mucosa.
  • Guaifenesin — This medicine can help you cough up secretions.
  • Antibiotics — Your doctor may decide to give you antibiotics if the infection seems to be caused by bacteria. Although, studies have shown that antibiotics are not effective in treating acute sinusitis.
  • Over-the-counter medicine — You can use acetaminophen, ibuprofen, or aspirin to treat sinus pain.
    • Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye’s syndrome. Ask your doctor which other medicines are safe for your child.


Surgery is a last resort for people with very troublesome, serious chronic sinusitis. It includes:

  • Repair of a deviated septum
  • Removal of nasal polyps
  • Functional endoscopic sinus surgery — A lighted scope is used to enlarge the sinuses to improve drainage.
  • Balloon sinuplasty — A catheter with a balloon attached is inserted into the sinuses. The balloon is inflated to open the sinuses passages.

If you are diagnosed with sinusitis, follow your doctor’s instructions.

Sinusitis – Prevention

If you have a tendency to get sinusitis following a cold or allergy attack, try these preventive measures:

  • 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.
  • If you have allergies, consider using cortisone nasal spray or antihistamines to decrease inflammation.
  • If you get a cold, drink lots of fluids and use a decongestant (either pills or nasal spray).
  • Blow your nose gently, while pressing one nostril closed.
  • Try not to fly in an airplane when you are congested. If you must fly, use a nasal spray decongestant to decrease inflammation prior to take-off 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.

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