Sinusitis

What is Sinusitis?

Sinusitis is an inflammation or infection of one or more of the sinuses that drain into the nose. It occurs most often in the sinuses located near the cheekbones called that maxillary sinuses. The lining of the nose and sinuses normally produces a protective layer of mucus to trap bacteria and inhaled particles. When the mucus cannot drain properly, it accumulates in the sinus, allowing intruding bacteria to multiply and infection to develop.

Sinusitis most often occurs when the lining of the nose and sinuses become inflamed, swell and blocks one or more of the openings that allow the sinuses to drain. Several conditions, including infection (a cold or flu) and allergy may cause this inflammation.

Mucus may also build up in the sinus cavity when the cilia, the tiny hairs that extend from the lining, fail to clear the mucus from the sinuses. This may be caused by overuse of nasal decongestant sprays or blockage of the sinus opening by a peanut, raisin, or other object in the nose.

What are some of the Signs of Sinusitis?

Sinusitis may be difficult to recognize, especially in children, since symptoms are similar to those of common infections such as a cold or the flu. Sinus infection may occur six to eight times a year.

The most common signs of sinusitis are fever, a persistent yellow or green discharge from the nose, and chronic cough that worsens at night. You may also experience a headache, swelling around the eyes, bad breath, pain in the face, or frequent sneezing attacks with watery discharge from the nose. If you have asthma it may be made worse by sinusitis.

Most simple colds last 7 to 10 days. If your symptoms do not improve by the 10th day you may have a sinus infection. Patients with sinusitis will have nighttime cough and discharge from the nose that last longer than other common cold symptoms.

Acute sinusitis lasts less than 4 weeks, sub acute sinusitis lasts 4-6 weeks, and chronic sinusitis greater than 8 weeks. In patients with chronic sinusitis, fever and other symptoms are usually less severe, but they may persist for 3 months or more.

How will the doctor know that I have Sinusitis?

In most cases the doctor will know that you have sinusitis by listening to your history and by your examination.

How is Sinusitis treated?

Most patients, by the time they visit an Allergist-Immunologist, have had multiple courses of antibiotics for anywhere from 7-10 days, rarely as many as 14 days. Your doctor will most likely give you a course of antibiotics for at least 3 weeks. Not uncommonly your doctor will want to evaluate you at the end of an antibiotic course to see if there is any evidence of infection remaining. This is usually done by either a Nasal Endoscopy or a CT scan of the sinuses. Your doctor will decide by your history and preference which method to use if this needs to be performed.