Sinusitis

Rhinosinusitis (Sinusitis or Sinus Infection)

Overview

If you have nasal congestion, facial pressure, cough and thick nasal discharge, you may have rhinosinusitis, commonly referred to as sinusitis.

Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows air from the nose to enter the sinuses and mucus made in the sinuses to drain into the nose.

Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body’s reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities.

Humans have four pair of these cavities each referred to as the:

  1. frontal sinus (in forehead),
  2. maxillary sinus (behind cheeks),
  3. ethmoid sinuses (between the eyes), and
  4. sphenoid sinus (deep behind the ethmoids).

The four pair of sinuses are often described as a unit and termed the “paranasal sinuses.” The cells of the inner lining of each sinus are mucus-secreting cells, epithelial cells and some cells that are part of the immune system (macrophages, lymphocytes, and eosinophils).

What Causes it?

Lots of people. About 35 million Americans have sinusitis at least once each year. Conditions that can cause sinus blockage include:

For children, things that can cause sinusitis include:

Types

Symptoms

At least two of the four primary signs and symptoms of chronic sinusitis must be present with confirmation of nasal inflammation for a diagnosis of the condition. They are:

Other signs and symptoms can include:

Chronic sinusitis and acute sinusitis have similar signs and symptoms, but acute sinusitis is a temporary infection of the sinuses often associated with a cold. The signs and symptoms of chronic sinusitis last longer and often cause more fatigue. Fever isn’t a common sign of chronic sinusitis, but you might have one with acute sinusitis.

Is Chronic Sinusitis Treated Differently Than Acute Sinusitis?

Because chronic sinusitis is caused more by inflammation than infection, the treatments for chronic sinusitis are meant to control the inflammation. Salt water nasal irrigation and/or nasal steroid sprays are the main treatments for the symptoms of chronic sinusitis. It may help to look for other factors that can go along with chronic sinusitis and possibly make the problem worse, and have them treated too. Some of these factors are allergies, nasal polyps, asthma, and problems with the body’s ability to fight infections.

Do I Need Surgery For My Sinusitis?

Surgery for the sinuses is done when the symptoms can’t be controlled with medications and other treatments. The most common type of surgery for the sinuses is called endoscopic sinus surgery, because a pencil-sized scope (“endoscope”) is used to see inside the nose and sinuses and guide the surgery. The purpose of the surgery is to widen the natural drainage pathways between the sinuses and the nose, allowing mucus to get out of the sinuses and air to get in. Medications that are delivered to the surface of the nose and sinuses, like sprays and irrigations, can get into the sinuses better after surgery as well.

Risk factors

You’re at increased risk of getting chronic or recurrent sinusitis if you have:

Complications

Chronic sinusitis complications include:

Prevention

Take these steps to reduce your risk of getting chronic sinusitis:

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