Sinusitis is an inflammation of the sinuses that can be caused by viruses, bacteria, fungi, allergies, or even an autoimmune reaction.
Although uncomfortable and in some cases painful, it will often right itself without the need for medical intervention.
In this article, we will look at sinusitis in all of its forms, its diagnosis, symptoms, and treatment.
Contents of this article:
Fast facts on sinusitis
Here are some key points about sinusitis. More detail and supporting information is in the main article.
- Sinuses are hollow spaces behind the bones of your face
- There are four pairs of sinuses
- Allergies can cause sinusitis
- Chronic sinusitis can last more than 12 weeks
- Doctors often refer to sinusitis as rhinosinusitis
What is sinusitis?
Sinusitis is an inflammation of the paranasal sinuses.
Behind the bones of the face there are hollow spaces filled with air; these lead to the nose cavity and are called the sinuses.
Sinuses have the same mucous membrane lining as the nose.
The membrane produces a slimy secretion (mucus), keeping the nasal passages moist. The mucus traps dirt particles and germs.
Sinusitis is an inflammation of the paranasal sinuses. The inflammation could be caused by a virus, bacteria, or fungus.
The infection may also be the result of an allergic or autoimmune reaction - when the immune system attacks healthy cells.
How long does sinusitis last?Depending on the type of sinusitis, recovery time can vary:
Lasts up to a maximum of 4 weeks
Acute sinusitis is most often caused by the common cold, which is a mild infection caused by a virus. In the majority of cases, home remedies are suitable treatments. However, if the sinusitis continues, it can lead to serious infections and complications.
Typically, with acute sinusitis, the patient's sinuses become inflamed and swollen. This stops the drainage and causes a build-up of mucus. Doctors may refer to this as acute rhinosinusitis.
Acute sinusitis can make it hard to breathe through the nose. The area next to the eyes and nose may feel swollen. There may also be facial pain and a headache. Sometimes, a patient with acute sinusitis may have a fever.
Lasts from 4 to 12 weeks
This type of sinusitis refers to an acute sinusitis that has not got better. Symptoms will be similar to acute sinusitis, possibly less severe.
Lasts at least 12 weeks, or keeps coming back
Chronic sinusitis is usually caused by an infection. However, it can also be caused by nasal polyps (growths in the sinuses), as well as a deviated septum.
As with acute and subacute sinusitis, the sinuses become inflamed and swollen, causing blockage and mucus build up. The patient may find it hard to breathe through the nose and might experience facial pain and a headache.
Symptoms of sinusitisAcute, subacute, and chronic sinusitis present a variety of symptoms:
Acute sinusitis signs and symptoms
Symptoms of sinusitis might include a blocked nose, cough, and congestion.
If the patient has two or more of these symptoms, and/or thick, green or yellow nasal discharge, they may be diagnosed with acute sinusitis.
- Facial pain and pressure
- Blocked nose
- Nasal discharge
- Poor sense of smell
These symptoms may also be present:
Chronic sinusitis signs and symptoms
The following signs and symptoms may have been present for at least 8 weeks:
- Congested, puffy face
- Blocked nose
- Nasal cavity has pus
- A high temperature (fever)
- Nasal discharge
These symptoms may also be present:
- Halitosis (bad breath)
Treatments for sinusitis
In the majority of cases, sinusitis will resolve itself without treatment. Many patients find that home treatments provide some relief. These treatments include some OTC (over-the-counter) medications.
- Steam inhalation - breathing steam from a bowl of hot water - not boiling. The water may have some drops of menthol oil. Although patients do feel they experience some relief, this treatment has not been scientifically proven. Standing or sitting in a very steamy shower may sometimes provide the same effect.
- Nasal Irrigation - this is also known as sinus irrigation, sinus rinse, or sinus lavage. It is a home procedure that involves a salt water rinse to clear the nasal passages.
- Warm compress - applying a warm compress gently to the affected areas of the face can relieve some symptoms.
- Sleeping with the head raised - prop up pillows so that the head is higher than it usually is; this may reduce the amount of pressure around the sinuses and reduce discomfort and pain.
- Painkillers - painkillers can improve the fever.
- Decongestant tablets - these may reduce swelling and allow the sinuses to drain.
- Decongestant sprays - same effect as the tablets. However, patients should not use them for more than 1 week. The risk of making the blockage worse rises if decongestant sprays are used for prolonged periods. If in doubt, ask a doctor or pharmacist for advice.
If none of these home remedies work after about a week, the individual should see a doctor. The doctor may decide the sinusitis has been caused by a bacterial infection and prescribe antibiotics.
Antibiotics use in sinusitis
A review of clinical trials found that while antibiotics can provide small improvements in uncomplicated sinusitis cases, most patients recover without the drugs within 2 weeks.
However, in patients with severe symptoms, like high fever, severe pain in cheeks, and a swelling of the face, antibiotic treatment is justified.
The most commonly prescribed antibiotics for sinusitis are:
If symptoms are prolonged, antibiotics might be prescribed.
- Beta-Lactams - these include penicillins, such as Amoxicillin. These antibiotics work by interfering with the bacterial cell walls. These are effective against a wide range of bacteria. People who are allergic to penicillins should not take these, instead the following may be used: cefpodoxime, cefdinir, and cefuroxime; these are effective for mild to moderate sinusitis.
- Macrolides and Azalides - these are sometimes used in patients with mild to moderate symptoms who are allergic to penicillin and include erythromycin, azithromycin (Zithromax), and clarithromycin (Biaxin). They have anti-inflammatory properties, which might help patients with chronic sinusitis.
- Trimethoprim-Sulfamethoxazole - these are also useful alternatives to patients who are allergic to penicillin.
- Fluoroquinolones (Quinolones) - these include Levofloxacin (Levaquin), sparfloxacin (Zagam), and gatifloxacin (Tequin). They are extremely effective against the common bacteria that cause sinusitis.
- Tetracyclines - these drugs help stem the spread of bacteria, and include doxycycline, tetracycline, and minocycline. Patients may have side effects, including skin sensitivity to sunlight, sore throat sensation, and tooth discoloration.
- Ketolides - effective against antibiotic-resistant bacterial strains.