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Sinusitis

What are sinuses?

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The sinuses are cavities, or air-filled pockets, that are near the nasal passage. The sinuses make mucus. This is the fluid that cleans the bacteria and other particles out of the air we breathe. There are 4 different types of sinuses:

  • Ethmoid sinus. Located around the area of the bridge of the nose, it is present at birth and continues to grow.

  • Maxillary sinus. Located around the area of the cheeks, it is also present at birth and continues to grow.

  • Frontal sinus. Located in the area of the forehead, it does not develop until around seven years of age.

  • Sphenoid sinus. Located deep in the face, behind the nose, it does not develop until adolescence.

What is sinusitis?

Sinusitis is an infection of the sinuses near the nose. These infections usually occur after a cold or after an allergic inflammation. There are 4 types of sinusitis:

  • Acute. Symptoms of this type of infection last less than 12 weeks and get better with the appropriate treatment.

  • Chronic. These symptoms last longer than 12 weeks.

  • Recurrent. This means you have 3 or more episodes of acute sinusitis in a year.

What causes sinusitis?

Sometimes, a sinus infection happens after a cold. The cold causes inflammation of the nasal passages that can lead to obstruction of the opening of the paranasal sinuses, which can lead to infection in the sinuses. Allergies can also lead to sinusitis because of the swelling of the nasal tissue and increased production of mucus. Other possible conditions that can lead to sinusitis include:

  • Abnormalities in the structure of the nose

  • Enlarged adenoids

  • Diving and swimming

  • Infections from a tooth

  • Nose injury

  • Foreign objects that are stuck in the nose

  • Secondhand smoke

When secretions are blocked, bacteria will sometimes begin to grow. This leads to a sinus infection, or sinusitis.

What are the symptoms of sinusitis?

The symptoms of sinusitis depend on your age. The following are the most common symptoms:

  • Nasal congestion

  • Thick, colored nasal drainage

  • Postnasal drainage (down the back of the throat)

  • Headache

  • Cough

  • Pain or soreness over sinuses

  • Fever

  • Loss of smell

The symptoms of sinusitis may look like other conditions or medical problems. Always consult a doctor for a diagnosis.

How is sinusitis diagnosed?

Usually, your doctor can diagnosis sinusitis based on your symptoms and physical examination. In some situations, additional tests may be performed to confirm the diagnosis. These may include:

  • Cultures from the sinuses

  • Sinus X-rays

  • Sinus computed tomography (CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Treatment for sinusitis

Your health care provider will figure out the best treatment based on:

  • How old you are 

  • Your overall health and medical history

  • How sick you are

  • How well you can handle specific medications, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Treatment of sinusitis may include the following:

Acute sinusitis may get better on its own. When it doesn’t, your health care provider may prescribe:

  • Antibiotics. If your sinuses are infected with bacteria, antibiotics are given to kill the bacteria. If after 3 to 5 days, your symptoms haven't improved, the health care provider may try a different antibiotic.

  • Allergy medicines. For sinusitis caused by allergies, antihistamines and other allergy medications can reduce swelling.

Note: Do not use over-the-counter decongestant nasal sprays without checking with your health care provider. They may make symptoms worse.

Recurrent acute sinusitis is also treated with antibiotic and allergy medicines. Your health care provider may refer you to an ear, nose and throat (ENT) specialist for testing and treatment.

Treatment for chronic sinusitis may include:

  • Referral to a specialist. Your provider may recommend you see an ear, nose and throat (ENT) specialist.  

  • Antibiotics. Your may need to take antibiotics for a longer time. If bacteria aren't the cause, antibiotics won't help.

  • Inhaled corticosteroid medicine. Nasal sprays or drops with steroids are often prescribed.

  • Other medicines.  Nasal sprays with antihistamines and decongestants, saltwater (saline) sprays or drops, or mucolytics or expectorants (to loosen and clear mucus) may be prescribed.

  • Allergy shots (immunotherapy). If you have nasal allergies, shots may help reduce your reaction to allergens such as pollen, dust mites, or mold.

  • Surgery. Surgery for chronic sinusitis is an option.

Care may also include the following:

  • Fluids. A glass of water or juice every hour or two is a good rule. Fluids help thin mucus, allowing it to drain more easily. Fluids also help prevent dehydration.

  • Saline wash. This helps keep the sinuses and nose moist. Ask your health care provider or nurse for instructions.

  • Warm compresses. Apply a warm, moist towel to your nose, cheeks, and eyes to help relieve facial pain.