Sinus Infection

Overview

Sinus infection (known as sinusitis) is a major health problem. It afflicts 31 million people in the United States. Americans spend more than $1 billion each year on over-the-counter medications to treat it. Sinus infections are responsible for 16 million doctor visits and $150 million spent on prescription medications. People who have allergies, asthma, structural blockages in the nose or sinuses, or people with weak immune systems are at greater risk.

Sinus infection symptoms

A bad cold is often mistaken for a sinus infection. Many symptoms are the same, including headache or facial pain, runny nose and nasal congestion. Unlike a cold, sinus infection symptoms may be caused by bacterial infections. It often requires treatment with antibiotics (drugs that kill the germs causing the infection).

Sinus infection diagnosis

If you think you have a sinus infection, see your allergist for proper diagnosis. In most cases, sinus infection treatment is easy. By stopping a sinus infection early, you avoid later symptoms and complications.

What is sinusitis?

Sinusitis is an inflammation of the sinuses. It is often caused by bacterial (germ) infection. Sometimes, viruses and fungi (molds) cause it. People with weak immune systems are more likely to develop bacterial or fungal sinus infection. Some people with allergies can have “allergic fungal sinus infection.” Acute sinus infection lasts three to eight weeks. A sinus infection lasting longer than eight weeks is considered chronic.

The sinuses are air-filled cavities. They are located:

  • Within the bony structure of the cheeks
  • Behind the forehead and eyebrows
  • On either side of the bridge of the nose
  • Behind the nose directly in front of the brain

Normal sinuses are lined with a thin layer of mucus that traps dust, germs and other particles in the air. Tiny hair-like projections in the sinuses sweep the mucus (and whatever is trapped in it) towards openings that lead to the back of the throat. From there, it slides down to the stomach. This continual process is a normal body function.

A sinus infection stops the normal flow of mucus from the sinuses to the back of the throat. The tiny hair-like “sweepers” become blocked when infections or allergies cause tiny nasal tissues to swell. The swelling traps mucus in the sinuses.

Some people have bodily defects that contribute to sinus infection. The most common of these defects are:

  • Deformity of the bony partition between the two nasal passages
  • Nasal polyps (benign nasal growths that contain mucus)
  • A narrowing of the sinus openings

People with these defects often suffer from chronic sinus infections.

Symptoms

Common symptoms of sinus infection include:

  • Postnasal drip
  • Discolored nasal discharge (greenish in color)
  • Nasal stuffiness or congestion
  • Tenderness of the face (particularly under the eyes or at the bridge of the nose)
  • Frontal headaches
  • Pain in the teeth
  • Coughing
  • Fever
  • Fatigue
  • Bad breath

Sinus infection (sinusitis) is often confused with rhinitis, a medical term used to describe the symptoms that accompany nasal inflammation and irritation. Rhinitis only involves the nasal passages. It could be caused by a cold or allergies.

Allergies can play an important role in chronic (long-lasting) or seasonal rhinitis episodes. Nasal and sinus passages become swollen, congested, and inflamed in an attempt to flush out offending inhaled particles that trigger allergies. Pollen are seasonal allergens. Molds, dust mites and pet dander can cause symptoms year-round.

Asthma also has been linked to chronic sinus infections. Some people with a chronic nasal inflammation and irritation and/or asthma can develop a type of chronic sinusitis that is not caused by infection. Appropriate treatment of sinus infection often improves asthma symptoms.

How is sinus infection diagnosed?

Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your allergist will look for:

  • Redness
  • Swelling of the nasal tissues
  • Tenderness of the face
  • Discolored (greenish) nasal discharge
  • Bad Breath

If your sinus infection lasts longer than eight weeks, or if standard antibiotic treatment is not working, a sinus CT scan may help your allergist diagnose the problem. Your allergist may examine your nose or sinus openings. The exam uses a long, thin, flexible tube with a tiny camera and a light at one end that is inserted through the nose. It is not painful. Your allergist may give you a light anesthetic nasal spray to make you more comfortable.

Treatment

Antibiotics

Antibiotics are standard treatments for bacterial sinus infections. Antibiotics are usually taken from 10 to 28 days, depending on the type of antibiotic. Because the sinuses are deep-seated in the bones, and blood supply is limited, longer treatments may be prescribed for people with longer lasting or severe cases.

Antibiotics help eliminate a sinus infection by attacking the bacteria that cause it, but until the drugs take effect, they do not do much to alleviate symptoms. Some over-the-counter medications can help provide relief.

Nasal decongestant sprays

Topical nasal decongestants can be helpful if used for no more than three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which the nasal passages swell shut, called rebound phenomenon.

Nasal decongestants and antihistamines

Over-the-counter combination drugs should be used with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them when prescribed by your allergist.

Topical nasal corticosteroids

These prescription nasal sprays prevent and reverse inflammation and swelling in the nasal passages and sinus openings, addressing the biggest problem associated with sinus infection. Topical nasal corticosteroid sprays are also effective in shrinking and preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the bloodstream and could be used over long periods of time without developing “addiction.”

Nasal saline washes

Nasal rinses can help clear thickened secretions from the nasal passages.

Surgery

If drug therapies have failed, surgery may be recommended as a last resort. It is usually performed by an otolaryngologist. Anatomical defects are the most common target of surgery.

Your surgeon can fix defects in the bone separating the nasal passages, remove nasal polyps, and open up closed passages. Sinus surgery is performed under either local or general anesthesia, and patients often can go home on the same day.

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