What is sinusitis?

Acute sinusitis is an inflammation of the mucous membranes inside the nose and sinuses. Sinuses are the hollow spaces in your skull around the eyes and nose. Acute sinusitis often follows a cold. Acute sinusitis causes thick, discolored mucus that drains from the nose or down the back of the throat. It also can cause pain and pressure in your head and face along with a stuffy or blocked nose.

In most cases, sinusitis gets better on its own in 1 to 2 weeks. But some mild symptoms may last for several weeks. Sometimes antibiotics are needed if there is a bacterial infection.

There are two main types of sinusitis: acute (short-term) and chronic (long-term). Acute sinusitis often develops after a cold or viral infection. Swelling, inflammation, and a buildup of mucus caused by the cold can block the normal drainage of the nose and sinuses. This makes it easier for germs like viruses and bacteria to grow in the sinuses. Most sinus infections get better on their own. But antibiotics may be needed if there is a bacterial infection.

When inflammation in the sinuses lasts 12 weeks or longer, it is called chronic sinusitis. Anything that causes the sinuses to become inflamed and stay inflamed can lead to chronic sinusitis. This includes nasal allergies and nasal polyps that block the nasal passages or reduce drainage from the nose and sinuses. A deviated nasal septum can also make it worse.

Treatment depends on if you have acute or chronic sinusitis. A steroid nose spray along with a saline nose wash may relieve symptoms. If you have a bacterial infection, you may take antibiotics. Other medicines may be used. Surgery may be needed when sinusitis is chronic or severe and doesn't get better with medicines.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Your doctor will ask about your current symptoms and how long you've had them. The doctor will also do a physical exam. You probably won't need any other tests if you have acute sinusitis. But you may need more tests if treatment doesn't help, if you have chronic sinusitis, or if you have complications.

Certain medicines may be used to treat acute or chronic sinusitis. Your doctor will let you know which medicine can help treat the type of sinusitis you have. You may use more than one medicine. Medicines may include:

• Corticosteroids. They reduce inflammation in the nasal passages. Examples include fluticason (Flonase) and mometasone (Nasonex). Most of the time, they are used as a nasal spray.
• Decongestants. They reduce the swelling of the mucous membranes in the nose. Some examples are oxymetazoline (such as Afrin) and phenylephrine (such as Neo-Synephrine).
• Analgesics. They relieve pain. They include acetaminophen (such as Tylenol) and ibuprofen (such as Advil).
• Antibiotics. They are prescribed to treat sinusitis caused by bacteria if your symptoms don't go away with time and self-care. They may be prescribed when symptoms of acute sinusitis don't start to get better within 10 days or if symptoms get better before 10 days but then get worse again.
• Allergy medicines. They may be used to treat nasal allergies (allergic rhinitis) or nasal polyps.

Be safe with medicines. Read and follow all instructions on the label.

Sinusitis may be diagnosed and treated by any of the following health professionals:

• Family medicine physician
• Pediatrician
• Internist
• Nurse practitioner (NP)
• Physician assistant (PA)

Your doctor may refer you to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist) who can provide a more specialized examination of the nasal passages and upper throat. Referral to an ENT specialist may be beneficial for people in whom nasal polyps or other conditions causing blockage of the nasal cavity are suspected. Diagnosis and surgical treatment of chronic or complicated cases of sinusitis may be done by an ENT specialist.

An infectious disease specialist may be needed when sinusitis is caused by something unusual or when rare complications (such as an infection of the facial bones) occur. An allergist (immunologist) may be needed when allergies are suspected to be causing or contributing to sinus problems.

• Use saline (saltwater) nasal washes. This can help keep your nasal passages open and wash out mucus and allergens.
  • You can buy saline nose washes at a grocery store or drugstore. Follow the instructions on the package.
  • You can make your own at home. Add 1 teaspoon of non-iodized salt and 1 teaspoon of baking soda to 2 cups of distilled or boiled and cooled water. Fill a squeeze bottle or a nasal cleansing pot (such as a neti pot) with the nasal wash. Then put the tip into your nostril, and lean over the sink. With your mouth open, gently squirt the liquid. Repeat on the other side.
• Try a steroid nasal spray. This is especially good for chronic sinusitis.
• If needed, take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• For acute sinusitis, try a decongestant nasal spray like oxymetazoline (Afrin). Do not use it for more than 3 days in a row. Using it for more than 3 days can make your congestion worse.
• If the doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not taking more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.
• Breathe warm, moist air. You can use a steamy shower, a hot bath, or a sink filled with hot water. Avoid cold, dry air. Using a humidifier in your home may help. Follow the directions for cleaning the machine.

Endoscopic surgery may be needed when medicine has failed to improve or cure chronic sinusitis. It is the preferred method of surgery for most cases of chronic sinusitis that require surgery.

Sinusitis is an inflammation of the mucous membranes inside the nose and sinuses. Symptoms of sinusitis include pain in the face, a stuffy nose, and drainage from the nose. Sinusitis can be either acute (short-term) or chronic (long-term). Sinusitis is chronic when it lasts 12 weeks or more.

The cause of sinusitis varies depending on which type you have. Acute sinusitis is mainly caused by viruses but can also be caused by bacteria. The cause of chronic sinusitis may not be known, or it may be related to allergies, infections, or nasal polyps.