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Sinusitis is an inflammation of the mucous membranes of one or more of the sinuses. Sinusitis lasting anything from a few days up to a month is called acute sinusitis.
When Sinusitis is an ongoing problem lasting three months or more, it is termed chronic sinusitis.
Sinusitis is one of the most common problems of the respiratory system. It can affect people of any age, although children have very small or non-existent sinuses until the age of around five or six, so tend not to get sinusitis.

What are sinuses?

Sinuses are hollow air spaces, located in the bone cavities. They make mucus, a fluid that cleans bacteria and other particles out of the air you breathe. These hollow spaces, located within the skull or bones of the head surrounding the nose, include:
  • Frontal sinuses over the eyes in the brow area
  • Maxillary sinuses inside each cheekbone
  • Ethmoid sinuses just behind the bridge of the nose and between the eyes
  • Sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes
Normal human anatomy tells us that each sinus has an opening into the nose for the free exchange of air and mucus. There is also a continuous mucous membrane lining that coats all the sinuses.  Therefore, it isn't hard to assume that, anything that causes swelling or infection in the nose also can affect the sinuses.  

What is sinusitis?

Sinusitis is an inflammation of the lining of one or more of the sinus cavities in the facial bones around your nose. Most cases of sinusitis are acute infectious sinusitis, which lasts less than four weeks. If the signs and symptoms of sinusitis last more than 12 weeks, or if a person has frequent attacks of sinusitis, he may have chronic sinusitis
The incidence of this condition is very high: chronic sinusitis is one of the most common chronic diseases in the United States, affecting an estimated 33 million people each year.

Signs and symptoms of sinusitis

Although theoretically the condition affects only sinus lining, it affects the whole body functioning and can make your life miserable.  
Some of the most common symptoms are:
  • Congestion that makes it difficult for breathing through nose
  • A sore throat
  • Pain, tenderness and swelling around eyes, cheeks, nose or forehead
  • A headache when you wake up in the morning is typical of a sinus problem.
  • Bad breath or loss of smell
  • Fever
  • Pain in eyes: The ethmoid sinuses are near the tear ducts in the corner of your eyes. Therefore, inflammation of these cavities often causes swelling of the eyelids and tissues around your eyes, and pain between your eyes.
  • Reduced sense of smell or taste
  • A cough
  • Tooth pain
  • Bad breath
  • Fatigue

Possible causes of sinusitis

The most common causes of sinusitis are a viral, bacterial or fungal infection of the upper respiratory tract including viruses that cause the common cold.
Mechanism of the infection is simple! When an infection such as a cold inflames and swells mucous membranes in your nose, the swollen membranes obstruct the sinus openings and keep mucus from draining. And this blockage is the critical point! As drainage becomes blocked, it creates an environment in which bacteria and viruses trapped in the sinuses can grow.
Sinus infections are usually (9 out of 10 cases in adults; 5-7 out of 10 cases in children) caused by a virus and they are less commonly (1 out of 10 cases in adults; 3-5 out of 10 cases in children) caused by bacteria. Secondary bacterial infection is also possible.[1
There are several other, less possible, causes of sinusitis and they include [1]:
  • Allergies
    Inflammation that occurs with allergies may easily block sinuses because it is the very same mechanism.
  • Deviated nasal septum
    In this condition, the wall between the nostrils, usually called- the nasal septum is crooked or unsymmetrical, which may restrict or block sinus passages, creating a perfect environment for infections.
  • Nasal polyps
    Growths of tissue may restrict the nasal passages, slowing drainage and allowing infections to grow.
  • Other medical conditions
    Several other conditions can affect sinuses also. For example, people with cystic fibrosis or HIV and other immune deficiency diseases are more likely to develop sinusitis compared to the healthy individuals!
Chronic sinusitis - It can be difficult to determine the cause of chronic sinusitis. Some experts think it is an infectious disease, but others are not certain. It is an inflammatory disease that often occurs in people with asthma.

Risk factors for developing sinusitis

  • Having asthma
  • Overuse of nasal decongestants
  • Chronic drug misuse (snorting substances)
  • Having a foreign body in your nose
  • Frequent swimming or diving
  • Dental work
  • Pregnancy
  • Changes in altitude (flying or diving)
  • Air pollution and smoking
  • Gastro-esophageal reflux disease (GERD)
  • Hospitalization that involves installed nasogastric tube

Complications of sinusitis

The most common complication of sinusitis is a possible aggravation of asthma attack. Severe complications from sinusitis are rare, but the fact is that they can be life-threatening. Most common complications are:
  • Meningitis
    The infection may spread to the bones of your eyes or to the membranes that protect your brain called meninges, causing severe brain damage. It can be a fatal condition!
  • Vision problems
    Although it happened rarely, some patients experienced reduced vision or even blindness if the infection spread to their eye socket.
  • Blood vessel complications
    Infection that spreads to the veins around sinuses can cause aneurysms and blood clots that interfere with the blood supply to your brain, which can lead to infarctions!

Diagnosis of sinusitis

Because patient’s nose can get stuffy during some other conditions such as common cold, a patient may confuse simple nasal congestion associated with cold with sinusitis. A cold, however, usually lasts about 7 to 14 days and disappears without treatment. Acute sinusitis often lasts longer and typically causes more symptoms than just a cold.
Physical examination including a detailed patient’s history is sometimes enough to set the appropriate diagnosis. If your symptoms are vague or persist, your health care provider may order a CT (computed tomography) or X-ray scan to confirm that you have sinusitis.
If the doctor can't set the right diagnosis just from physical examination, it can do several other tests! Laboratory tests to diagnose chronic sinusitis may include:
  • Blood tests
    These tests are done to rule out other conditions associated with sinusitis like an immune deficiency disorder or cystic fibrosis.
  • Cultures
    These are special blood tests which are done to detect bacterial or fungal infection.
  • Biopsy
    A biopsy is done to determine the health state of the cells lining the nasal cavity.

Treatment of sinusitis

  •   Acute sinusitis
    If a person is diagnosed with acute sinusitis, several treatment options could be beneficial. The most common may include the use of:
  • Decongestants to reduce congestion
  • Antibiotics to control a bacterial infection, if present
  • Pain relievers to reduce any pain

Problem is that sometimes patients are using these over-the-counter or prescription decongestant nose drops and sprays for to long! They should be used for only a few days because they can lead to even more congestion and swelling of nasal passages. If a virus causes the sinusitis, then the antibiotics will not help and the condition will usually resolve spontaneously in a few days!

  • Chronic sinusitis
    Doctors often find it difficult to treat chronic sinusitis successfully, because the symptoms persist even after taking antibiotics for an extended period. Many general practitioners are treating chronic sinusitis as though it is an infection, by using antibiotics and decongestants, but not with success. Others use both antibiotics along with steroid nasal sprays.
Treatment options that could relieve some symptoms are:
  • Inhaling steam from a vaporizer or a hot cup of water  
  • Saline nasal spray can give relief.
  • Gentle heat applied over the inflamed area is comforting.

Surgery for sinusitis

The most common surgery done today is called Functional endoscopic sinus surgery. This operation the natural openings from the sinuses are enlarged to allow drainage. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare. Surgery should be considered only after failure of medical treatment. [2] Other types of surgery can correct bent nasal cartilage. This operation is called septoplasty.  Other operations can remove nasal polyps that may be the cause of sinusitis.

Tips for prevention of sinusitis

There are several things that every person could do to reduce the risk of developing sinusitis. Some of these steps are [1]:
  • Minimize the risk of upper respiratory infections, which can be done by limiting close contact with people who have colds and washing hands frequently with soap and water.
  • Quit smoking. Tobacco smoke can cause irritation and inflammation of the lining of the sinuses and nose. Inflammation can result in blocked nasal passages.
  • Avoid polluted air. Contaminants in the air can irritate and inflame your lungs and nasal passages.
  • Use of humidifiers


  • Steam your sinuses often by inhaling steam several times a day. It will stimulate drainage from the sinuses.
  • Warm compresses should be applied daily.
  • Every person diagnosed with sinusitis should drink as many fluids as it can because diluting secretions and promoting drainage by consuming additional liquids is very beneficial.
  • Don't drink alcohol. Drinking alcohol can worsen the swelling of the lining of the sinuses and nose.
  • Have flu vaccinations
  • Keep your allergy symptoms under control
  • Avoid swimming in pools treated with chlorine, which irritates the lining of the nose and sinuses.