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Sinusitis

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Acute sinusitis; Sinus infection; Sinusitis - acute

Treatment:

Try the following measures to help reduce congestion in your sinuses:

• Use a humidifier.
• Spray with nasal saline several times per day.
• Inhale steam 2 - 4 times per day (for example, sitting in the bathroom with the shower running).
• Drink plenty of fluids to thin the mucus.
• Apply a warm, moist washcloth to your face several times a day.

Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them beyond 3 - 5 days can actually worsen nasal congestion.

Also, for sinus pain or pressure:

• Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
• Try acetaminophen or ibuprofen.
• Avoid flying when you are congested.

If self-care measures are not working, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) specialist.

Nasal corticosteroid sprays may be used to decrease swelling, especially if you have swollen structures (such as nasal polyps) or allergies.

Antibiotics are used to cure the particular infection causing sinus inflammation.

Other antibiotics may be used depending on the type of organism present. Acute sinusitis should be treated for 10 - 14 days, while chronic sinusitis should be treated for 3 - 4 weeks.

Surgery to clean and drain the sinuses may also be necessary, especially in patients with recurrent episodes of inflammation despite medical treatment. An ENT specialist, also known as an otolaryngologist, can perform this surgery.

Most fungal sinus infections require surgery. Finally, surgical repair of a deviated septum or nasal polyps may prevent recurrence.

Expectations (prognosis):

Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems.

Complications:

Although very rare, complications may include:

• Abscess
• Antibiotic resistance, a situation in which the bacteria causing your sinusitis no longer responds to medicines used to treat the infection
• Meningitis, an infection that spreads to the brain
• Orbital cellulitis, an infection that spreads to the area surrounding the eye
• Osteomyelitis, an infection that spreads to the bones in the face

Calling your health care provider:

Call your doctor if:

• Your symptoms last longer than 10 - 14 days or you have a cold that gets worse after 7 days
• You have a severe headache, unrelieved by over-the-counter pain medicine
• You have a fever
• You still have symptoms after taking all of your antibiotics properly

A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.

References:

Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for management of acute bacterial sinusitis in children 1-18 years of age. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006 Jul 7. 17 p.

Slavin RG. The diagnosis and management of sinusitis. J Allergy Clin Immunol. Dec 2005; 116(6 Suppl): S13-47.

• Review Date: 7/25/2007
• Reviewed By: James L. Demetroulakos, M.D., F.A.C.S., Department of Otolaryngology, North Shore Medical Center, Salem, MA. Clinical Instructor in Otology and Laryngology, Harvard Medical School. Review provided by VeriMed Healthcare Network.

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