Sinusitis Problems

Definition

“Sinusitis” simply means your sinuses are inflamed—red and swollen—because of an infection or another problem. There are several types of sinusitis.

Health experts usually identify them as follows:

• Acute, which lasts up to 4 weeks
• Subacute, which lasts 4 to 12 weeks
• Chronic, which lasts more than 12 weeks and can continue for months or even years
• Recurrent, with several attacks within a year

Because African Americans lead the nation in respiratory ailments such as asthma, allergies, and sinus problems, a growing concern is evident regarding the indoor air quality of many African-American homes.

Alternative Names

Acute sinusitis; Sinus infection; Sinusitis – acute; Sinusitis – chronic; Rhinosinusitis

Causes

The paranasal sinuses, like the inside of your nose, are lined with a thin layer of tissue called the mucous membrane, which produces mucus. This mucus flows out through openings of the paranasal sinuses and into the nose. When these openings become blocked, your sinuses are affected.

Anything that causes swelling in the nose can block the openings between your paranasal sinuses and your nose, including a cold, an allergic reaction such as hay fever, or a reaction to some chemical to which you’ve been exposed. The blockage causes air and mucus to become trapped within the sinuses. This may cause pain and thickened mucus.

• The pain of a sinus attack arises because the trapped air and mucus put pressure on the mucous membrane of the sinuses and the bony wall behind it. Also, when a swollen membrane at the opening of a paranasal sinus prevents air from entering into the sinuses, it can create a vacuum that causes pain.
• Mucus thickens because it loses its water content as it stays trapped inside the sinuses for a long time. In addition, inflammation leads to extra materials being secreted into the mucus, causing thickening.

Symptoms

One of the most common symptoms of any type of sinusitis is pain, and the location depends on which sinus is affected.

• If you have pain in your forehead, the problem lies in your frontal sinuses.
• Pain in your upper jaw and teeth, with tender cheeks, may mean your maxillary sinuses are involved.
• Experiencing pain between your eyes, sometimes with swelling of the eyelids and tissues around your eyes, and tenderness when you touch the sides of your nose may mean sinusitis has developed in your ethmoid sinuses.
• Pain in your neck, with earaches, and deep achiness at the top of your head could be a sign that your sphenoid sinuses are involved (though these sinuses are affected less often).

Most people with sinusitis have pain or tenderness in several places, and their symptoms usually do not clearly indicate which sinuses are inflamed. Pain is not as common in chronic sinusitis as it is in acute sinusitis.

In addition to the pain, people who have sinusitis (acute or chronic) often have thick nasal secretions that can be white, yellowish, greenish, or blood-tinged. Sometimes these secretions drain in the back of the throat and are difficult to clear. This is referred to as “post-nasal drip.” Also, cases of acute and chronic sinusitis are usually accompanied by a stuffy nose, as well as by a general feeling of fullness over the entire face.

Less common symptoms of sinusitis (acute or chronic) can include the following:

• Tiredness
• Decreased sense of smell
• Cough that may be worse at night
• Sore throat
• Bad breath
• Fever

On very rare occasions, acute sinusitis can result in brain infection and other serious complications. Because your nose can get stuffy or congested when you have a condition like the common cold, you may confuse simple nasal congestion with sinusitis. A cold usually lasts about 7 to 14 days and goes away without treatment. Acute sinusitis often lasts longer and typically causes more symptoms than a cold.

Exams and Tests

Your healthcare professional usually can diagnose acute sinusitis by noting your symptoms and examining your nose and face. If your symptoms do not clearly indicate that you have sinusitis or if they persist for a long time and do not get better with treatment, your healthcare professional may order a CT (computerized tomography) scan (a form of X-ray that shows some soft-tissue and other structures that cannot be seen in conventional X-rays) to confirm that you have sinusitis.

Other laboratory tests your healthcare professional may use to check for possible causes of chronic rhinosinusitis include the following:

• Blood tests to rule out conditions, such as an immune deficiency disorder, that are associated with sinusitis
• A sweat test or a blood test to rule out cystic fibrosis
• Tests on the material inside your sinuses to detect bacterial or fungal infection

Treatments

After diagnosing sinusitis and identifying a possible cause, your healthcare professional can suggest various treatments.

Acute Sinusitis

If you have acute sinusitis, your healthcare professional may recommend the following:

• Antibiotics to control a bacterial infection, if present
• Pain relievers to reduce any pain
• Decongestants (medicines that shrink the swollen membranes in the nose and make it easier to breathe)

Even if you have acute sinusitis, your healthcare professional may choose not to use an antibiotic because many cases of acute sinusitis will end on their own. However, if you do not feel better after a few days, you should contact your healthcare professional again.

Chronic Rhinosinusitis

Healthcare professionals often find it difficult to treat chronic rhinosinusitis successfully. They have two options to offer patients: medicine and surgery.

Medicine

• Nasal steroid sprays are helpful for many people, but most people still do not get full relief of symptoms with these medicines.
• A long course of antibiotics is occasionally recommended by physicians, but results from clinical research do not support this kind of antibiotic use.
• Saline (saltwater) washes or saline nasal sprays can be helpful in chronic rhinosinusitis because they remove thick secretions and allow the sinuses to drain.
• Oral steroids, such as prednisone, may be prescribed for severe chronic rhinosinusitis. However, oral steroids are powerful medicines with significant side effects, and these medicines typically are prescribed when other medicines have failed.

Research is needed to develop new, more effective treatments.

Surgery

When medicine fails, surgery may be the only alternative for treating chronic rhinosinusitis. The goal of surgery is to improve sinus drainage and reduce blockage of the nasal passages. Nasal surgery usually is performed to accomplish the following:

• Enlarge the natural openings of the sinuses
• Remove nasal polyps
• Correct significant structural problems inside the nose and the sinuses if they contribute to sinus obstruction

Although most people have fewer symptoms and a better quality of life after surgery, problems can reoccur, sometimes even after a short period of time.

In children, problems can sometimes be eliminated by removing the adenoids. These gland-like tissues, located high in the throat behind and above the roof of the mouth, can obstruct the nasal passages.

Possible Complications

Although very rare, complications may include:

• Abscess
• Bone infection (osteomyelitis)
• Meningitis
• Skin infection around the eye (orbital cellulitis)

When to Contact a Medical Professional

Call your doctor if:

• Your symptoms last longer than 10 – 14 days or you have a cold that gets worse after 7 days
• You have a severe headache, unrelieved by over-the-counter pain medicine
• You have a fever
• You still have symptoms after taking all of your antibiotics properly
• You have any changes in your vision during a sinus infection

Preventions

There are no methods that have been scientifically proven to prevent acute or chronic sinusitis. Your healthcare professional may recommend the following measures that can help:

• Keep your nose as moist as possible with frequent use of saline sprays or washes.
• Avoid very dry indoor environments and use a humidifier, if necessary. Be aware, however, that a humid environment also may increase the amount of mold, dust mite, or cockroach allergens in your home; this is important only if you are allergic to any of those organisms.
• Avoid exposure to irritants such as cigarette and cigar smoke or strong odors from chemicals.
• Avoid exposure to substances to which you are allergic.
• If you haven’t been tested for allergies and you are getting frequent sinus infections, ask your healthcare professional to give you an allergy evaluation or refer you to an allergy specialist.
• Avoid long periods of swimming in pools treated with chlorine, which can irritate the lining of the nose and sinuses.
• Avoid water diving, which forces water into the sinuses from the nasal passages.

Natural Remedies

Breathe freely again by clearing blocked passageways and easing sinus pressure. According to research or other evidence, the following self-care steps may help you find some relief and fight off infection:

What You Need To Know:

• Wipe out irritants Keep your environment free of irritants and allergens that can trigger sinus congestion, such as dust, mold, smoke, chemical fumes, and animal dander
• Steam clean with aromatic oils Use steam inhalation with eucalyptus oil or products containing menthol to reduce nasal stuffiness
• Try nasal irrigation Prepare a warm, salt-water solution in a special ceramic pot known as a “neti lota” pot and pour it through your nose to relieve your sinuses
• Uncover food allergies Work with a knowledgeable practitioner to find out if food allergens may contribute to your sinus congestion
• Get a checkup Visit your healthcare provider to find out if your sinus congestion may be caused by an infection, inhalant allergy, or other treatable medical condition

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full sinus congestion article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.