Sinusitis
What is it?
Sinusitis is an inflammation, usually due to infection, of one or more of the four sets of sinus cavities within the facial skeleton.When irritated, the mucous membrane lining the sinus may swell and block the small drainage channels that permit mucus to flow into the nose. The buildup in pressure often results in headache, nasal congestion, and facial pain. Acute sinusitis is a common disorder that often follows a cold or flu; chronic sinusitis refers to persistent or recurrent episodes that are generally milder than acute cases. Sinusitis often subsides on its own and responds well to home treatment. Rarely, infection may spread to the eyes or brain, possibly leading to vision loss, meningitis, or brain abscess.
What Causes It?
- A viral or bacterial infection that spreads to the sinuses from the nose.
- Anatomical irregularities, such as a deviated septum.
- Nasal allergy resulting in swelling and polyps.
- Swimming in contaminated water.
- Infection spread from abscesses in the upper teeth.
- Chronic sinusitis may be caused by irritation from dust, air pollutants, or excessive exposure to tobacco smoke, or result from an untreated acute condition.
Prevention
- If you have allergies, limit exposure to allergens and use antihistamines and/or nasal steroid sprays.
- When you have a cold, use a cool-mist humidifier and decongestants to promote drainage.
- Chronic sinusitis sufferers should drink plenty of liquids, and avoid tobacco smoke and alcohol.
Diagnosis
- Patient history and physical examination are needed.
- Removal of fluid from the maxillary sinus using a needle or endoscope-directed suction may be necessary to determine the type of bacterial infection.
- X-rays may be used to locate the infected site(s).
How to Treat It
- Steam inhaled from a basin of hot water can thin the mucus and ease symptoms.
- Over-the-counter oral or nasal decongestants may reduce swelling. Nasal decongestants should not be used for more than three days. People with high blood pressure, heart disease, arrhythmias, or glaucoma should ask their doctor about the safety of using oral decongestants.
- Nonprescription pain relievers, ice packs, or warm compresses may soothe sinus pain. In severe cases codeine may be prescribed.
- Antihistamines are used to treat allergic sinusitis.
- Steroid nasal sprays may be prescribed to reduce inflammation, though they are more useful over the long term in reducing swelling of nasal membranes, thus prompting normal sinus drainage.
- Antibiotics are used for bacterial infections; they may be taken for two to six weeks in difficult cases.
- Endoscopy (use of a lighted instrument) may be used to survey the sinuses and clear blockage.
- Surgery may be needed to drain sinuses in very rare cases. Early surgical drainage is often recommended for frontal sinusitis.
- Hospitalization and intravenous antibiotics are required for severe bacterial sinusitis.
When to Call a Doctor
- Call a doctor if symptoms persist longer than two weeks or are accompanied by bloody nasal discharge.
- EMERGENCY See a doctor right away if you develop redness, pain, or bulging of an eye, paralysis of eye movements, or nausea and vomiting in association with other symptoms of sinusitis.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.