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Alternative Names Return to topAcute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis
Definition Return to top
Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.
See also: Chronic sinusitis
Causes Return to top
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
Sinusitis can be:
Acute sinusitis is caused by damage to the lining of the sinuses from surgery or infections. Chronic sinusitis may be caused by bacteria or a fungus.
The following may increase your risk or your child's risk of developing sinusitis:
Symptoms Return to top
The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. Symptoms include:
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 8 weeks.
Symptoms of sinusitis in children include:
Exams and Tests Return to top
The doctor will examine you or your child for sinusitis by:
Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis.
Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctor who specializes in ear, nose, and throat problems (ENT).
However, these tests are not very sensitive at detecting sinusitis, and are often considered unnecessary.
A CT scan of the sinuses may also be used to help diagnose sinusitis. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.
If you or your child has chronic or recurrent sinusitis, other tests may include:
Treatment Return to top
Try the following measures to help reduce congestion in your sinuses:
Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them beyond 3 - 5 days can actually worsen nasal congestion.
Also, for sinus pain or pressure:
Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:
At some point, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) or allergy specialist.
Other treatments for sinusitis include:
Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
Surgery to clean and drain the sinuses may also be necessary, especially in patients whose inflammation returns, despite medical treatment. An ENT specialist (also known as an otolaryngologist) can perform this surgery.
Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.
Outlook (Prognosis) Return to top
Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.
Possible Complications Return to top
Although very rare, complications may include:
When to Contact a Medical Professional Return to top
Call your doctor if:
A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.
Prevention Return to top
The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
Other tips for preventing sinusitis:
References Return to top
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for management of acute bacterial sinusitis in children 1 to 18 years of age. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006.
Slavin RG, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005;116:S13-S47.
Wald ER. Sinusitis. In: Long SS, Pickering LK, Prober CG, eds. Principles and Practice of Pediatric Infectious Disease. 3rd ed. Philadelphia, Pa:Churchill Livingstone Elsevier;2008:chap 34.
Rosenfeld RM, Singer M, Jones S. Systematic review of antimicrobial therapy in patients with acute rhinosinusitis. Otolaryngol Head Neck Surg. 2007;137:S32-S45.Update Date: 4/21/2009 Updated by: Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.