Sinusitis
Sinusitis is a come condition that causes blockage of the sinus cavities inside the nose through infection or inflammation.
What is Sinusitis?
Sinusitis occurs when the lining of sinuses of the nose swell and have inflammation. Sinusitis is a common condition, diagnosed in 28.5 million Americans every year! Bacterial or viral infection, allergic inflammation, and physical obstruction can lead to sinusitis. Some of the common symptoms of sinusitis include facial pain and pressure, swelling sensation of the face, mucus drainage, smell loss, headache,
runny nose, and bad breath. When symptoms persist for over 3 months, the condition is called chronic sinusitis. Read on to learn about all the different types of sinusitis, the ways to diagnose it, and how doctors treat this distressing condition.
What are the symptoms of Sinusitis?
Sinusitis causes troublesome symptoms in the head and face. Nasal congestion is a common symptom of sinusitis related to a sinus infection, chronic inflammation, or nasal polyps. Facial pain, loss of smell, and mucus coming from the nose are also common symptoms. Other symptoms may include headache, fever, cough, and earache. You should seek immediate medical attention if you experience symptoms such as vision changes, a bulge on the forehead, and mental state changes as these may be red flags for complications of sinusitis.
What are the types of Sinusitis?
Sinusitis can be divided into a few different types, including:
- Acute Sinusitis (less than 1 month)
- Subacute Sinusitis (1 to 3 months)
- Chronic Sinusitis (3 months or longer)
- Recurrent Acute Sinusitis (recurring episodes)
Let's explore some of these categories of sinusitis.
Acute Sinusitis
Acute sinusitis is inflammation of the paranasal (around the nose) sinuses for less than 3 months. The majority of cases of acute sinusitis are caused by respiratory virus, but symptoms lasting over 7-10 days is more likely secondary to bacteria. Very rarely, fungal infection can be involved.
SYMPTOMS OF ACUTE SINUSITIS
- Headache
- Loss of the sense of smell
- Facial pain or pressure
- Stuffy or runny nose
- Postnasal drip (mucus down the back of the nose)
- Sore throat
- Fever
- Coughing
- Fatigue
- Bad breath
TREATMENT OF ACUTE SINUSITIS
- Control the symptoms. If the sinus infection is present for less than 7-10 days, not worsening, and without worrisome findings (eye swelling, severe headache, severe fever, or neurologic changes), using over-the-counter decongestants, sinus rinses, and nasal steroid sprays can be helpful. For a detailed description of over-the-counter sinusitis remedies, click here for more information on Symptom Control of Common Cold, Allergies, and Sinusitis.
- Antibiotics. Treatment of sinus infections lasting over a week or worsening often requires antibiotics. You doctor can prescribe the right sinusitis treatment based on your history. Occasionally, endoscopically-guided cultures of the puss in the nose can help guided antibiotic therapy, especially in cases of resistant bacterial infection.
- Steroids. Nasal steroid sprays or oral corticosteroids (such as prednisone or a Medrol Dosepak) can relief symptoms of swelling in the sinusitis or allergy attacks.
Chronic Sinusitis
Chronic sinusitis is inflammation of the paranasal (around the nose) sinuses for 3 months or longer. Chronic sinusitis can be caused by many factors, such as bacteria, chronic inflammation (swelling), structural problems with the nose or sinuses, allergies, and nasal polyps.
SYMPTOMS OF CHRONIC SINUSITIS
- Nasal congestion/obstruction (stuffy nose)
- Loss of the sense of smell
- Facial pain/pressure
- Drainage in the back of nose
- Drainage from the front of the nose
- Fatigue
TREATMENT OF CHRONIC SINUSITIS
Determining the right treatment for chronic sinusitis can be a complex process. Your doctor needs to gather information on the duration, frequency of symptoms, probable cause, and location of the sinusitis. It is also important to distinguish infectious, inflammatory, and structural problems leading to chronic sinusitis. Because each patient requires different treatment strategies, treatment for chronic sinusitis will depend on the cause of the sinusitis. Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) may also require special therapies. Antibiotics, anti-inflammatory drugs, nasal rinses, allergy therapies, and sinus surgery are some of the treatments options available for chronic sinusitis.
What causes Sinusitis?
Sinusitis is the inflammation of the sinus cavities, which are the air-filled spaces in the skull that are located near the nose. There are four pairs of sinuses that are lined with mucus membranes. When these sinuses are inflamed, the mucus membranes swell. The result is a stuffy nose, pain, and a runny nose.

How is Sinusitis diagnosed?
Sinusitis is a common condition that is typically diagnosed by a doctor who will ask about your symptoms and do a physical examination. Chronic sinusitis has specific tests that may be ordered by your doctor. The first is an X-ray or CAT scan of your face and sinuses. If your doctor suspects a nasal polyp is causing your sinusitis, they may request you see an otolaryngologist or ENT to perform a nasal endoscopy. During this procedure, your doctor will use a small camera to view the inside of your nose, sinuses, and throat.
How is Sinusitis treated?
Medical therapy can resolve most cases of sinusitis but surgery or other minimally invasive procedures may be required when medical therapy fails to relieve the problems. There are many medications that can help but they should be tailored to the individual.
Medicines to Treat Sinusitis
Here is a list of commonly used medicines used to treat sinusitis:
- Over-The-Counter (OTC) Medicines
- Nasal Sprays
- Allergy Treatment
- Antibiotics
- Corticosteroids
- Antihistamines
- Antileukotrienes
- Saline nasal irrigations
Procedures for Sinusitis Treatment
This list includes many of the procedures and surgeries used to treat sinusitis:
- Functional Endoscopic Sinus Surgery (FESS)
- Balloon Sinuplasty
- Inferior Turbinate Surgery
- Endoscopic Septoplasty
These procedures are used to treat other symptoms sinus patients often report.
- Eustachian Tube Dilation
- Clarifix for chronic rhinitis
- Nasal valve implant with Latera
- VivAer for nasal airway obstruction
- RhinAer for chronic rhinitis
- Microdebrider nasal polypectomy
- SINUVA steroid-eluting implant for ethmoid sinus polyposis
- Propel steroid-eluting implant for chronic sinusitis
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