Sinusitis


Sinus disease is a major health problem. It afflicts 31 million people in the United States. Americans spend more than $1 billion each year on over-the-counter medications to treat it. Sinus disease is responsible for 16 million doctor visits and $150 million spent on prescription medications. People who have allergies, asthma, structural blockages in the nose or sinuses, or people with weak immune systems are at greater risk. If you have nasal congestion, facial pressure, cough and thick nasal discharge, you may have rhinosinusitis, commonly referred to as sinusitis. Your sinuses are hollow cavities within your cheekbones, around your eyes and behind your nose. They contain mucus, which helps to warm, moisten and filter the air you breathe. When something blocks the mucus from draining normally, an infection can occur.

ACUTE SINUSITIS

Acute sinusitis refers to sinusitis symptoms lasting less than four weeks. Most cases begin as a common cold. Symptoms often go away within a week to 10 days; but in some people, a bacterial infection develops.

CHRONIC SINUSITIS

Chronic sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment.

SYMPTOMS

  • Postnasal drip
  • Discolored nasal discharge (greenish in color)
  • Nasal stuffiness or congestion
  • Tenderness of the face (particularly under the eyes or at the bridge of the nose)
  • Frontal headaches
  • Pain in the teeth
  • Coughing
  • Fever
  • Fatigue
  • Bad breath
  • Sinus disease is often confused with rhinitis, a medical term used to describe the symptoms that accompany nasal inflammation and irritation. Rhinitis only involves the nasal passages. It could be caused by a cold or allergies.

Allergies can play an important role in chronic (long-lasting) or seasonal rhinitis episodes. Nasal and sinus passages become swollen, congested, and inflamed in an attempt to flush out offending inhaled particles that trigger allergies. Pollen are seasonal allergens. Molds, dust mites and pet dander can cause symptoms year-round.

Asthma also has been linked to chronic sinus disease. Some people with a chronic nasal inflammation and irritation and/or asthma can develop a type of chronic sinus disease that is not caused by infection. Appropriate treatment of sinus disease often improves asthma symptoms.

Sinusitis may also be caused by an infection, a fungus, deviated nasal septum, and nasal polyps or in rare cases an immune system deficiency.

If you think you have sinus disease, see our allergists for proper diagnosis. In most cases, sinus disease treatment is easy. By stopping a sinus infection early, you avoid later symptoms and complications.

TREATMENT

Antibiotics

Antibiotics are standard treatments for bacterial sinusitis. Antibiotics are usually taken from 3 to 28 days, depending on the type of antibiotic. Because the sinuses are deep-seated in the bones, and blood supply is limited, longer treatments may be prescribed for people with longer lasting or severe cases. Overuse and abuse of antibiotics have been causing a major increase in antibiotic resistance. Therefore, patients with sinus symptoms should consider taking an antibiotic only if symptoms (including discolored nasal discharge) persist beyond 7-10 days. Antibiotics help eliminate sinus disease by attacking the bacteria that cause it, but until the drugs take effect, they do not do much to alleviate symptoms. Some over-the-counter medications can help provide relief.

Nasal Decongestant Sprays

Topical nasal decongestants can be helpful if used for no more than three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which the nasal passages swell shut, called rebound phenomenon.

Antihistamines

Antihistamines block inflammation caused by an allergic reaction so they can help to fight symptoms of allergies that can lead to swollen nasal and sinus passages.

Nasal Decongestants and Antihistamines

Over-the-counter combination drugs should be used with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them when prescribed by your doctor.

Topical Nasal Corticosteroids

These prescription nasal sprays prevent and reverse inflammation and swelling in the nasal passages and sinus openings, addressing the biggest problem associated with sinusitis. Topical nasal corticosteroid sprays are also effective in shrinking and preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the blood stream and could be used over long periods of time without developing “addiction.”

Nasal Saline Washes

Nasal rinses can help clear thickened secretions from the nasal passages.

Surgery

If drug therapies have failed, surgery may be recommended as a last resort. Anatomical defects are the most common target of surgery, and an allergist would usually refer you to an otolaryngologist.