Sinusitis is a medical term used to describe inflammation (swelling and irritation) of the paranasal sinuses. Because many cases of sinusitis are caused by an infection, you may hear "sinusitis" and "
sinus infection" used interchangeably.
What Are the Paranasal Sinuses?
The paranasal sinuses are hollow air spaces located within the skull. They include the frontal, maxillary, ethmoid, and sphenoid sinuses. These sinuses connect to the nasal passages through an opening that allows movement of air and mucus in between the nose and sinuses.
Types of Sinus Infections
There are two main types of sinusitis: acute and chronic.
Acute sinusitis is diagnosed when symptoms have lasted no longer than four weeks.
Chronic sinusitis is diagnosed when symptoms have lasted for at least 12 weeks, despite medical treatment.
Sinusitis may also be classified as subacute sinusitis and recurrent sinusitis.
Most of the time,
acute sinusitis is caused by an infection with a virus (this is known as acute viral sinusitis). The same virus will often cause common
cold symptoms at the same time.
Healthcare providers once believed that bacteria were the main cause of a
chronic sinus infection. What they have come to learn, though, is that it is a lot more complex than just a simple infection. Researchers continue to look for the exact cause or causes of
chronic sinusitis.
Researchers do know that certain things increase the likelihood for long-term inflammation and swelling of the sinus and nasal passages, and the inability for the sinuses to drain properly.
Signs and Symptoms of Sinusitis
There are a number of common signs and symptoms of a sinus infection in adults. The most common symptoms in people with acute sinusitis include:
- Nasal congestion or blockage
- Drainage of thick, yellow-to-green mucus (which can drain out the nose or down the back of the throat)
- Face pain or discomfort that is worse when bending over
- Tooth pain or discomfort.
Other symptoms, such as a fever or cough, are less common.
Most symptoms of sinusitis develop over 1 day and improve within 7 to 10 days. Symptoms tend to be at their worst from day 3 to day 6.
When to See a Healthcare Provider
In most cases, it is difficult to know whether a
sinus infection is caused by bacteria or a virus. There is no treatment available to speed up the recovery of viral
acute sinusitis. And in some cases, bacterial acute sinusitis will clear up on its own. Therefore, healthcare providers often recommend treating possible sinus infections at home.
However, if the following symptoms are present for more than seven days, you should see your healthcare provider:
- Face or tooth pain, especially if it is only on one side
- Thick, yellow-to-green discharge from the nose
- Cheek tenderness or pain (this is where your maxillary sinuses are).
You should also contact your healthcare provider if symptoms were getting better but suddenly get worse.
Reasons to contact your healthcare provider right away include:
- Double vision
- Decreases in vision
- Drooping eyelid
- Swelling around the eyelid
- Redness around the eyelid
- Severe headache
- High fever (over 102.5°F or 39.2°C)
- Severe facial pain
- Stiff neck
- Shortness of breath
- Changes in mental state.
The two main goals when treating a sinus infection are to decrease inflammation and relieve symptoms. Most treatments do not shorten the course of the illness.
Some different options for treating symptoms include:
- Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®), or acetaminophen (Tylenol®) for pain relief and/or fever.
- Irrigating the nose with a nonmedicated saline solution or spray several times a day. This helps clear the nasal passages and decreases the need for pain medicine (see Nasal Irrigation).
- Nasal decongestants and steroid nasal sprays to reduce congestion.
Most sinus infections do not require antibiotics -- this is because the majority of infections are caused by a virus. Antibiotics have no effect on viruses, but will be prescribed if the healthcare provider suspects bacterial sinusitis. Antibiotic medications can control a bacterial infection and decrease the chance of complications.
How Long Do Symptoms Last?
Most people with acute viral sinusitis get better on their own within 7 to 10 days. Many cases of acute bacterial sinusitis also get better on their own or with the help of antibiotics.
If your symptoms are not getting better, or if they come back, you should be seen again by your healthcare provider. It may be possible that the antibiotic did not completely eliminate the infection. A different antibiotic or further testing may be recommended.
Possible Complications With Sinusitis
Complications are rare with sinusitis. If they do occur, they could include:
