Acute sinusitis
Introduction of acute sinusitis
Sinusitis, also known as a sinus infection or rhinosinusitis, is inflammation of the sinuses that results in symptoms.
Acute sinusitis (acute rhinosinusitis) causes the cavities around your nasal passages (sinuses) to become inflamed and swollen. This interferes with drainage and causes mucus to build up.
With acute sinusitis, it might be difficult to breathe through your nose. The area around your eyes and face might feel swollen, and you might have throbbing facial pain or a headache.
Acute sinusitis is most commonly due to a cold causing viral infection. However, it can be due to noninfectious causes as well. According to the American Academy of Otolaryngology, acute sinusitis is common. It affects around 1 in 8 adults per year.
Symptoms of acute sinusitis
Acute sinusitis symptoms often include:
Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (postnasal drainage)
Nasal obstruction or congestion, causing difficulty breathing through your nose
Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead that worsens when bending over
Ear pressure
Headache
Aching in your upper jaw and teeth
Reduced sense of smell and taste
Cough, which might be worse at night
Bad breath (halitosis)
Fatigue
Fever
Causes of acute sinusitis
Acute sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops.
In some cases, infection spreads to a cheekbone (maxillary) sinus from an infected tooth.
Other risk factors may include?
Hay fever or another allergic condition that affects your sinuses
A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumors
A medical condition such as cystic fibrosis or an immune system disorder such as HIV/AIDS
Complications of acute sinusitis
Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.
Meningitis. This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.
Other infections. Uncommonly, infection can spread to the bones (osteomyelitis) or skin (cellulitis).
Partial or complete loss of sense of smell. Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell.
Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.
Prevention of acute sinusitis
Take these steps to help reduce your risk of getting acute sinusitis:
Avoid upper respiratory infections. Minimize contact with people who have colds. Wash your hands frequently with soap and water, especially before your meals.
Manage your allergies. Work with your doctor to keep symptoms under control.
Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.
Use a humidifier. If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis. Be sure the humidifier stays clean and free of mold with regular, thorough cleaning.
Diagnosis of acute sinusitis
Physical examination: Your doctor will feel for tenderness in your nose and face and look inside your nose.
Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
Imaging studies. A CT scan or MRI can show details of your sinuses and nasal area. While not recommended for uncomplicated acute sinusitis, imaging studies might help identify abnormalities or suspected complications.
Nasal and sinus cultures. Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.
Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that's responsible for your nasal flare-ups.
Treatment of acute sinusitis
Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Self-care techniques are usually all you need to ease symptoms.
Symptomatic Treatments
Your doctor may recommend treatments to help relieve sinusitis symptoms, including:
Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase AQ, Qnasl, others).
Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few days. Otherwise they may cause the return of more severe congestion (rebound congestion).
OTC pain relievers, such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
Antibiotics
Antibiotics usually aren't needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment.
Your doctor might wait and watch to see if your bacterial acute sinusitis worsens. However, severe, progressive or persistent symptoms might require antibiotics. If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur.
Immunotherapy
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat your symptoms.
