Introduction

Sinusitis is a fairly common condition.  It can develop following a cold, upper respiratory infection, or allergic reaction.  Environmental irritants, certain medical conditions, and structural abnormalities can contribute to sinusitis.

Sinusitis causes pressure and pain in the head and face.  It can also cause nasal congestion, coughing, fever, and a sore throat.  Symptoms may be relieved with over-the-counter medications.  Antibiotics can treat specific types of infection.  Treatment for contributing medical conditions or surgery may help recurrent or chronic sinusitis.

Anatomy

Your sinuses are spaces in your skull.  You have four sets of sinuses, for a total of eight.  They are located in the bones behind your forehead, cheeks, nose, and eyes.  The paranasal sinuses are located in the bones around your nose, eyes, and cheeks.

Your nose and sinuses are filled with air and lined with mucus membranes.  The mucus membrane helps to moisten air as you breathe and acts as a filtering system.  Small hairs, called cilia, are located on the surface of the mucus membranes.  The cilia move mucus out of the sinuses.  The mucus drains through small openings in your nose, called Ostia, and is swallowed or removed when you blow your nose.

Causes

Sinusitis results when the sinuses cannot drain.  Swelling of the mucus lining or a buildup of mucus can block the Ostia.  Certain irritants can damage the cilia rendering them unable to remove the mucus from the sinuses.  Because of blockage and mucus buildup, air cannot flow through the sinuses, and mucus cannot drain out of the sinuses.

Sinusitis can result when the mucus becomes too thick and has difficulty draining.  This occurs because of a lack of humidity, dehydrating medications, and certain diseases, such as cystic fibrosis.  The stagnant mucus environment is susceptible to infection.

Symptoms

Sinusitis causes nasal congestion, nasal discharge, and postnasal drip.  You may have a headache that intensifies when you lean forward.  Your face may feel tender or painful.  Sinusitis can cause a fever, sore throat, and coughing.  You may feel generally tired.  Your eyes may look puffy and you may have bad breath.

Diagnosis

Your doctor can begin to diagnose sinusitis by examining you.   If you have sinusitis that does not respond to treatments, recurrent sinusitis, or chronic sinusitis your doctor may order further studies to look for an underlying disorder.

Treatment

Sinusitis symptoms can be treated with over-the-counter decongestants, pain, and fever medications.  It may be helpful to use a humidifier or nasal saline mist.  You should drink plenty of fluids to thin the mucus.  Your doctor may prescribe medication to fight infection; however, antibiotics do not work on viral infections.  You should avoid irritants and allergy triggers if possible.

Prevention

You may be able to prevent sinusitis by avoiding irritants and allergens.  You should wash your hands frequently to prevent colds.  It is advantageous to not smoke or be around smoke.  You should not snort illegal drugs.  If you experience recurrent sinusitis, it may be helpful to be evaluated for allergies.

Am I at Risk

Risk factors may increase your likelihood of developing sinusitis, although some people that develop the condition do not have any risk factors.  You should tell your doctor about your risk factors and discuss your concerns. 

Risk factors for sinusitis:

_____ A cold, upper respiratory infection, or allergic reaction.
_____ Weakened immune systems from chemotherapy, HIV, or AIDS
_____ Asthma, allergies, or gastroesophageal reflux disease (GERD)
_____ Cystic fibrosis, immotile cilia syndrome, and Kartagener’s syndrome  
_____ A deviated septum, nasal bone spur, nasal polyp, or a foreign body in the nose
_____ Snorting illegal drugs, such as cocaine
_____ Changes in altitude from flying or scuba diving
_____ Overuse of over-the-counter nasal decongestants
_____ Hormonal changes during pregnancy
_____ Air pollution and smoke

Complications

Sinusitis can lead to sinus infections.  Antibiotics can treat some types of infections, while others may require surgery.  Rare complications include infections that can spread to the brain, bone, and area surrounding the eye.  Abscesses and blood clots are also rare complications. 

Sinusitis can recur or become chronic.  You should receive treatment for underlying medical conditions that cause sinusitis.  In some cases, surgery may be used to correct a deviated septum, remove nasal polyps, or clean and drain the sinuses.

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