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Sinusitis

What Is Sinusitis?

Sinusitis, also called a sinus infection, occurs when the sinuses, four air-filled chambers in the skull lined by cells that secrete mucus, become swollen and inflamed. As a result, a small opening (ostia) through which air usually enters the sinuses becomes blocked and mucous cannot drain out. If symptoms last longer than 12 weeks this is called chronic rhinosinusitis.

The exact cause of sinusitis is unknown, but suggested risk factors include:

  • Persistent viral infection that becomes bacterial

  • Hay fever or other similar allergic conditions

  • Nasal structural problems, such as polyps or a deviated septum

  • Underlying immune deficiencies

Symptoms

The most common and prominent symptom of sinusitis is nasal obstruction, when congestion completely blocks the nose. Other symptoms include:

  • Facial pressure/Pain — This discomfort is often found over the cheekbones, in the forehead or behind the eyes.

  • Reduced sense of smell — Temporary nasal irritation and/or congestion can lead to a loss of smell.

  • Runny nose — Patients may notice a green or yellow discharge.

  • Post-nasal drip — Patients may notice drainage down the back of their throat.

Other Non-Specific Symptoms

  • Bad breath — Nasal congestion can cause people to breathe from the mouth and dry out saliva.

  • Fatigue — Sleep disturbances caused by congestion and other symptoms can make people with sinusitis feel tired.

  • Persistent cough — This is often caused by postnasal drip.

  • Pressure or fullness in the ears — Nasal congestion can cause obstruction in the Eustachian tube, which runs between the nose and the middle ear.

Treatment Options

For chronic or acute sinusitis caused by an underlying condition, such as asthma, allergic rhinitis, a dental infection or fungal infection, the root cause will need to be treated first.

Conservative Treatment Options

  • Medications — Over-the-counter pain relievers, such as ibuprofen, may help with discomfort, and decongestant nasal sprays can help with blockage in the short term. A physician may prescribe nasal or oral steroids, or antibiotics. In rare cases, an antifungal medicine may be prescribed.

  • Nasal irrigation — Rinsing nasal passages with a saline (saltwater) solution can help relieve congestion.

  • Prevention — Smokers may find their symptoms improve if they stop smoking. People with allergies should do what they can to avoid allergens. Practicing good dental hygiene can prevent a dental infection.

Surgical Treatment Options

When sinusitis becomes chronic, surgery may help. Surgery for chronic sinusitis has one goal: to improve the sinuses' ability to drain and provide better access for topical medications. This is accomplished by surgically removing blockages, bone, and backed-up mucous/secretions.

  • Endoscopic sinus surgery: A head and neck surgeon inserts a thin tube with an attached light into the nose. This allows the surgeon to view the blockage and remove it.

    • This procedure can also be performed with image-guidance, using CT scan images to further guide the surgery and increase precision. This method is preferred when there are nasal polyps or when the nasal anatomy is irregular due to prior sinus surgery.

  • External approach to the sinuses: A Temple head and neck surgeon accesses the sinuses from inside the mouth or through a small incision on the face, through which blockages can be removed. This procedure may be performed when there are complications of sinusitis, such as an infection.

When to See a Doctor

If you're experiencing signs or symptoms of sinusitis, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat sinusitis.

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