Sinusitis is inflammation of the sinuses that occurs with an infection from a virus, bacteria, or fungus.
Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; Rhinosinusitis
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes). Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.
Sinusitis can occur from one of these conditions:
Sinusitis can be called:
The following may increase your risk or your child's risk of developing sinusitis:
The symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that gets worse after 5 - 7 days of symptoms. Symptoms include:
Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.
Symptoms of sinusitis in children include:
Exams and Tests
The doctor will examine you or your child for sinusitis by:
Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis.
Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctors who specialize in ear, nose, and throat problems (ENTs).
Imaging tests that may be used to decide on treatment are:
If you or your child has sinusitis that does not go away or keeps returning, other tests may include:
Try the following measures to help reduce congestion in your sinuses:
Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them for more than 3 - 5 days can make nasal stuffiness worse.
Also, for sinus pain or pressure:
MEDICATIONS AND OTHER TREATMENTS
Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:
Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.
At some point, your doctor will consider:
Other treatments for sinusitis include:
Surgery to enlarge the sinus opening and drain the sinuses may also be needed, especially in patients whose symptoms do not go away after 3 months of treatment, or in patients who have more than two or three episodes of acute sinusitis each year. An ENT specialist (also known as an otolaryngologist) can perform this surgery.
Most fungal sinus infections need surgery. Surgery to repair a deviated septum or nasal polyps may prevent the condition from returning.
Sinus infections can usually be cured with self-care measures and medical treatment. If you are having repeated attacks, you should be checked for causes such as nasal polyps or other problems, such as allergies.
Although very rare, complications may include:
When to Contact a Medical Professional
Call your doctor if:
A green or yellow discharge does not mean that you definitely have a sinus infection or need antibiotics.
The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
Other tips for preventing sinusitis:
Cincinnati Children's Hospital Medical Center. Evidence-based care guideline for management of acute bacterial sinusitis in children 1 to 18 years of age. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2006.
Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012; 54:e72-e112.
Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, et al. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2007;137:S1-S31.
Review Date: 7/30/2012
Reviewed By: Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.