Sinusitis
What are sinuses?
The sinuses are small, air-filled spaces inside the cheekbones and forehead. They make some mucus which drains into the nose through small channels. They are useful for giving quality to the voice.
What is sinusitis?
Sinusitis means inflammation of a sinus. Most bouts of sinusitis are caused by an infection.
Acute sinusitis means that the infection develops quickly (over a few days) and lasts a short time. Many cases of acute sinusitis last a week or so but it is not unusual for it to last more than two weeks. Sometimes it lasts longer.
Severe acute sinusitis is uncommon. Most people only ever have one or two bouts of acute sinusitis in their lives. However, some people have repeated (recurring) bouts of acute sinusitis.
Chronic sinusitis means that a sinusitis becomes persistent and lasts for longer than 12 weeks. Chronic sinusitis is uncommon.
How do you get acute sinusitis?
After a cold or the flu
In most people, acute sinusitis develops after a cold or flu-like illness. Colds and flu are caused by germs called viruses which may spread to the sinuses. The infection usually remains viral before clearing, causing a viral sinus infection. In a small number of cases, germs are called bacteria to add on to an infection that started with a virus. This can cause a bacterial sinus infection which can make the infection worse and last longer.
Spread from a dental infection
In some cases, the infection spreads to a cheekbone (maxillary) sinus from an infected tooth.
Other risk factors for sinus infection
In some people, one or more factors are present that may cause the sinuses to be more prone to infection. These include:
- Nasal allergy (allergic rhinitis).
- Other causes of a blockage to the sinus drainage channels, such as:
- Growths (nasal polyps).
- Objects pushed into the nose (especially in children, such as peas or plastic beads).
- Facial injury or surgery.
- Certain congenital abnormalities in children. (‘Congenital’ means they are born with these abnormalities).
- Asthma
- Cystic fibrosis
- A poor immune system
- Inflammatory disorders
- Rare tumors of the nose.
- Previous injuries to the nose or cheeks.
- Medical procedures such as ventilation or the insertion of a tube through the nose into the stomach (nasogastric tube).
- Smoking
What are the symptoms of acute sinusitis?
Symptoms that commonly occur include:
- Pain and tenderness over the infected sinus. The pain is often throbbing and worse when you bend your head forward. Chewing may be painful.
- Nasal symptoms. You may have either:
- A blocked nose.Both sides of your nose usually feel blocked. Your sense of smell may also go for a while.
- A runny nose.If the discharge is greeny/yellow, it is more likely that you have a germ (bacterial) infection in your sinuses. The green/yellow colour is due to infected mucus and pus. A runny nose may dry up if the sinus drainage channels become blocked with thick mucus. If this happens, pain and tenderness over the infected sinus may become worse.
- A high temperature (fever).This may develop and you may feel generally unwell.
Other symptoms that may occur include:
- Headache
- Bad breath
- Toothache
- Cough
- A feeling of pressure or fullness in the ears
- Tiredness
- Irritability
- Ear discomfort
- Snoring
- Mouth breathing
- Feeding difficulty
- Nasal speech
How is acute sinusitis diagnosed?
Your doctor can usually diagnose acute sinusitis from listening to your typical symptoms. They may also check to see if you have a temperature or if you have tenderness over your sinuses. They may examine your nose, as often the lining of the nose is swollen in acute sinusitis. Investigations are not usually needed to diagnose acute sinusitis. Occasionally, blood tests, X-rays or scans are advised if the diagnosis is not clear.
What are the treatments for sinusitis?
Are antibiotics needed?
Not usually. Most cases of acute sinusitis are due to an infection with a germ called a virus. Like with colds, the immune system usually clears the virus and symptoms generally go within a couple of weeks.
Antibiotics are sometimes useful for severe sinusitis. If your symptoms are severe or if you are very unwell.
Treatment to relieve symptoms
Some treatments may help to relieve symptoms whilst waiting for your immune system to clear the infection. These include pain medicines.
Decongestants are sometimes used for few days, if they are used for long, they may cause a worse rebound congestion in the nose.
- Keeping hydrated can be helpful, so have plenty of drinks.
- Warm face packs held over the sinuses may help to ease pain.
- Saline nasal drops may help to relieve congestion and blockage in the nose.
Note:See a doctor if symptoms become severe or do not ease within a week. (However, as mentioned, it is common to take 2-3 weeks for symptoms to go completely.) The sort of symptoms you should tell a doctor about include:
- Severe pain and/or swelling at the front of your head.
- Swelling around the eye.
- Swelling of the face.
- Bloodstained discharge coming from the nose.
You should also see a doctor if you have recurring bouts of sinusitis, as this may indicate an underlying problem.
Are there any complications from acute sinusitis?
Chronic sinusitis can sometimes develop from an acute sinusitis. This is the most common complication. Chronic sinusitis causes similar symptoms to acute sinusitis but lasts longer.