SINUSITIS

General Information

DEFINITION--Inflammation of the sinuses adjacent to the nose. The disorder may be acute (usually caused by an allergy or virus) or chronic (often a bacterial infection such as Staphylococcus).

BODY PARTS INVOLVED--The 8 sinuses (mucosa-lined air pockets) located within the facial bone structure and connected to the nose. Usually involved are the ethmoidal sinuses, located between the eyes; and the maxillary sinuses, located in the cheekbone.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Nasal congestion with green-yellow (sometimes blood-tinged) discharge.
• Feeling of pressure inside the head.
• Headache that is worse in the morning or when bending forward. With chronic sinusitis, the headache may occur daily for weeks at a time.
• Cheek pain that may resemble a toothache.
• Post-nasal drip.
• Cough (sometimes) that is usually non-productive.
• Tiredness; lack of energy; disturbed sleep (sometimes); fever (sometimes); eye pain.

CAUSES--

The sinuses add moisture (by producing mucus) to the air we breath. With sinusitis, the normal draining of this mucus is disrupted; fluid accumulates and becomes infected. Common causes include:

• Allergies; acute or chronic rhinitis (hay fever).
• Environmental irritants (tobacco smoke, dry air, other pollutants).
• Nasal polyps; deviated septum.
• Viral infection; fungal infection; surgical packing.

RISK INCREASES WITH

• Illness that has lowered resistance.
• Exposure to infected people.
• Immunosuppression due to illness or drugs.
• Swimming or diving injury.
• Abscessed tooth.

HOW TO PREVENT--Try to prevent the respiratory conditions that usually precede sinusitis (allergies, colds, flu), and if they do occur, treat them promptly. Avoid smoking.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests (depending on severity of infection and chronicity) may include laboratory blood studies, culture of mucus, endoscopy (See Glossary), x-rays or CT scan (See Glossary) of the sinuses.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.
• Chronic sinusitis not responding to other treatment may require surgery to drain blocked sinuses.

POSSIBLE COMPLICATIONS

• Meningitis or brain abscess (rare).
• Infection of bone or bone marrow (rare).
• Infections of the eye.

PROBABLE OUTCOME--Acute sinusitis usually clears up in 3 weeks with treatment. Recurrence is common and may lead to chronic sinusitis, which may require prolonged treatment with antibiotics (4-6 weeks).

How To Treat

GENERAL MEASURES--

• Warm moist air may help relieve sinus congestion. Use a vaporizer or breathe steam from a pan of boiled water (after removing it from the heat).
• Use warm compresses to relieve pain in the sinuses and nose.
• Don't allow other persons to use your nose drops. They will be contaminated.
• Avoid non-prescription nose drops or sprays. Use prescribed drops only for the recommended time. They can interfere with normal nasal and sinus function and become addictive, causing a rebound phenomenon (See Glossary). Ask your doctor about using saline nose drops (they are usually safe).

MEDICATION--

• Your doctor may prescribe: Nasal sprays, nose drops or oral decongestant medicine to reduce congestion. Antibiotics for any bacterial infection (antibiotics are not effective against viral infections).
• Antihistamines for allergies.
• Antifungal medicine for any fungal infection.
• For minor pain, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--Resume normal activities slowly.

DIET--No special diet, but drink extra fluids to help thin secretions.

Call Your Doctor If

The following occurs during treatment: Fever; bleeding from the nose; severe headache. Swelling of the face (forehead, eyes, side of the nose or cheek). Blurred vision or other eye symptoms.