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Ask a Doc - Sinusitis

Sinusitis, or sinus infection, is an inflammation of the tissue lining the sinuses.  The sinuses are cavities located in the head that are usually filled with air and are separate from the nasal passages.  Narrow passages connect the sinuses, which produce mucus that drains out of the nasal passages.  Drainage helps to keep sinuses free of bacteria, allergens, and other germs.  Typically, a normal patient can expect to experience 1 to 2 infections a year that would fit the diagnosis of acute sinusitis.  The symptoms of acute sinusitis include thick, yellow, or greenish mucus from the nose, congestion, and pain or tenderness around the eyes, cheeks, and forehead, and often fever.  Mucus color does not distinguish the type of infection a person has.  Symptoms must persist for at least two weeks.  Headache alone is not a reliable sign of a sinus infection.

There are several different types of sinusitis, which are categorized by the length of time that symptoms have been present:

  • Acute sinusitis – symptoms lasting at least two weeks, but less than four weeks
  • Subacute sinusitis – symptoms last four to 12 weeks
  • Chronic sinusitis – symptoms last for at least 12 weeks
  • Recurrent acute sinusitis – symptoms return four or more times in one year and last less than two weeks each occurrence
Sinus infections are caused by bacterial infections and are generally treated with antibiotics.  These types of infection are distinguished from a general upper respiratory infection such as the common cold or rhinovirus, with similar symptoms.  Symptoms last less than two weeks and are generally secondary to viruses.  Viral infections do not respond to antibiotics and should be treated symptomatically.

Chronic sinusitis can exacerbate underlying health conditions or habits, such as nasal allergies, smoking, asthma, a deviated septum, nasal polyps, or a weakened immune system.  In some cases, a primary care provider may refer a patient to a specialist, such as an otolaryngologist, also known as an ear, nose, and throat specialist (ENT) for surgical considerations.  Treatments for chronic sinusitis may include nasal saline rinses, intranasal steroid sprays, antihistamine sprays or pills, or in resistant cases, surgery.  The use of antihistamines should be reserved only for patients with allergy symptoms (itching watery eyes, sneezing, etc.) as they can thicken the mucous in patients who do not have allergies and worsen their sinus symptoms.  Patients should also avoid the use of topical decongestant sprays, such as Afrin®, for greater than 4 days, as these types of sprays can ultimately increase nasal congestion.  Nasal saline and steroid sprays do not cause this effect. 

Sinusitis is not contagious; however, the bacteria and viruses that can cause the respiratory infections can be spread to others.  Individuals should practice good hand hygiene and make sure that they cover their nose and mouth when coughing or sneezing.  Other ways to prevent sinusitis include using a saline nasal rinse as directed by a physician, managing allergy symptoms by taking prescribed medications and avoiding allergy triggers, such as dust, pollen, or smoke.  Using a humidifier, which adds moisture to the air, can help prevent sinusitis by keeping nasal passages from becoming too dry.  Physicians may also recommend the use of steroid nasal sprays as a prevention method.

| Posted On : 12/20/2023 1:49:13 PM