Have you ever felt like you had a cold that wouldn’t go away? If it hangs around for more than 10 days, or gets worse after it starts getting better, there’s a good chance you have sinusitis, a condition where infection or inflammation affects the sinuses.

What are the sinuses?

Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows air from the nose to enter the sinuses and mucus made in the sinuses to drain into the nose.

What is sinusitis?

Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body’s reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities.

How can I tell if I have acute sinusitis?

You have acute sinusitis when there have been up to 4 weeks of cloudy or colored (not clear) drainage from the nose plus one or both of the following:

  • a stuffy, congested or blocked nose or
  • pain, pressure or fullness in the face, head or around the eyes.
  • X-rays and CT scans are not usually necessary to diagnose acute sinusitis.

Acute Sinusitis: Diagnosed when symptoms last up to 4 weeks. It is usually caused by viruses or bacteria.

How can I tell if my acute sinusitis is caused by viruses or bacteria?

Acute viral sinusitis is likely if you have been sick less than 10 days and are not getting worse.

Acute bacterial sinusitis is likely when you do not improve at all within 10 days of getting sick or when you get worse within 10 days after beginning to get better.

Why is it important to tell if my sinusitis is caused by bacteria?

Because sinusitis is treated differently based on cause. Acute viral sinusitis does not benefit from antibiotics, but may be treated using pain relievers, steroid nasal sprays, or salt water irrigation in the nose. These treatments are good options for acute bacterial sinusitis too, but in addition, some patients with acute bacterial sinusitis may get better faster with an antibiotic.

What is chronic sinusitis?

Chronic Sinusitis: Lasts for 12 weeks or longer and is usually caused by prolonged inflammation, rather than a longstanding infection.

Chronic sinusitis lasts for a longer period of time than acute sinusitis and is likely caused by different things. Acute sinusitis is diagnosed when symptoms last up to 4 weeks. It is usually caused by viruses or bacteria. Chronic sinusitis is defined as lasting for 12 weeks or longer and is usually caused by prolonged inflammation, rather than a longstanding infection. Infection can be a part of chronic sinusitis, especially when it worsens from time to time, but is not usually the main cause.

Is chronic sinusitis treated differently than acute sinusitis?

Because chronic sinusitis is caused more by inflammation than infection, the treatments for chronic sinusitis are meant to control the inflammation. Salt water nasal irrigation and/or nasal steroid sprays are the main treatments for the symptoms of chronic sinusitis. It may help to look for other factors that can go along with chronic sinusitis and possibly make the problem worse, and have them treated too. Some of these factors are allergies, nasal polyps, asthma and problems with the body’s ability to fight infections.

Do I need surgery for my sinusitis?

Surgery for the sinuses is done when the symptoms can’t be controlled with medications and other treatments. The most common type of surgery for the sinuses is called endoscopic sinus surgery, because a pencil-sized scope (“endoscope”) is used to see inside the nose and sinuses and guide the surgery. The purpose of the surgery is to widen the natural drainage pathways between the sinuses and the nose, allowing mucus to get out of the sinuses and air to get in. Medications that are delivered to the surface of the nose and sinuses, like sprays and irrigations, can get into the sinuses better after surgery as well.

There are many over-the-counter saline solutions available, but patients can make their own saline solution at home:

  • 1 quart (4 cups) boiled or distilled water
  • 1 teaspoon baking soda
  • 1 teaspoon non-iodized salt

© 2017 American Academy of Otolaryngology — Head and Neck Surgery

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