What is sinusitis?

Sinuses are air-filled cavities in the bones of your face. These cavities are lined with mucus membranes. Sinusitis is the condition in which these membranes swell and become inflamed or the cavity becomes filled with infected material.

How does it occur?

A number of different irritants can cause sinusitis. Sinusitis often occurs after a cold, but not always. Bacteria, viruses, allergies, and even fungus can cause sinusitis. If your nasal bones have been injured or are deformed, causing partial blockage of the sinus openings, you are more likely to get sinusitis.

What are the symptoms?

Symptoms include:

• feeling of fullness and congestion in your head

• a headache that is most painful when you first wake up in the morning, and when you bend your head down or forward

• tenderness above, behind, or below the eyes

• sore cheeks, or what feels like a toothache or sore jaw

• chronic runny nose and congestion

• cough, especially at night

• a feeling of fluid draining in the back of your throat (postnasal drainage)

• morning and/or evening sore throat.

How is it diagnosed?

The doctor will give you a physical exam and sometimes take an x-ray to see the swelling or fluid in the sinus cavities.

How is it treated?

The simplest, least expensive treatment for mild sinusitis symptoms is nonprescription or prescription decongestants. Note that you should not use nonprescription decongestant nasal sprays for more than 3 days.

If nonprescription decongestants are not sufficient, or if the symptoms are severe, antibiotics are usually needed.

Occasionally a prolonged course of decongestants and antibiotics will be required, sometimes for 2 to 6 weeks.

In cases of chronic (recurrent) sinus infections, allergies may be the cause. A trial of antihistamines or prescription nasal sprays (steroids or cromolyn) may be indicated.

Sinus x-rays may be needed to confirm an infection or to look for causes such as a small benign growth or polyp in the sinuses.

In cases of chronic, severe sinusitis (not responding to usual treatment), a surgical drainage procedure may be necessary. In this type of surgery the doctor creates an extra or enlarged passageway in the wall of the sinus cavity, so the sinuses may easily drain through the nasal passages and remain free of infection.

How long will the effects last?

Symptoms may improve gradually over 3 to 10 days. Recovery time depends on the cause and severity of the sinusitis. Recovering from sinusitis is much like recovering from a cold.

How can I take care of myself?

• Avoid smoke, other inhaled irritants and allergens, such as animal dander.

• Add moisture to the air with a humidifier or a vaporizer, unless you have mold allergy (mold may grow in your vaporizer).

• Inhale steam from a basin of hot water or shower to relieve pain.

• Take antibiotics as prescribed. Use all of the medicine, even if you feel better; it's difficult to achieve good antibiotic concentrations in the sinuses and one usually feels well before all the bacteria have been killed.

• Use oral decongestants as directed.

• Never use nasal spray decongestants for more than 3 days. After 3 days they may cause symptoms to worsen.

What can I do to help prevent sinusitis?

To prevent sinusitis you must prevent the causes of sinusitis. Treat your colds and allergies promptly. If you have congestion often, recognizing your symptoms early and using decongestants may minimize your discomfort and prevent infections.

Humidify your home if the air is particularly dry.

If you have frequent, repeated sinus infections, consider having an allergy evaluation. If symptoms persist despite treatment for any allergies you may have, you might need an exam by an ear, nose, and throat doctor (otolaryngologist) to rule out physical (anatomic) obstruction by a polyp or deformed bone.