- Infections:
- Viral infections: The most common cause of acute sinusitis, often following a common cold or flu.
- Bacterial infections: Can develop if a viral infection lingers and leads to a secondary bacterial infection.
- Fungal infections: Less common but can occur, especially in people with weakened immune systems.
- Allergies: Allergic rhinitis (hay fever) can cause inflammation and swelling of the nasal passages and sinuses, leading to blockage.
- Nasal polyps: Small, noncancerous growths in the nasal passages or sinuses that can block drainage.
- Deviated septum: A displacement of the wall that divides the nostrils, which can narrow one or both nasal passages and obstruct sinus drainage.
- Other conditions:
- Asthma
- Cystic fibrosis
- Immune system disorders
- Dental infections (rarely, can spread to sinuses)
- Exposure to irritants like cigarette smoke or air pollution.
- Nasal congestion or stuffiness: Difficulty breathing through the nose.
- Thick, discolored nasal discharge: Often yellow, green, or cloudy.
- Pain, pressure, or tenderness in the face: Especially around the eyes, forehead, cheeks, or nose. This pain may worsen when bending forward.
- Postnasal drip: Mucus dripping down the back of the throat, causing a cough or throat clearing.
- Reduced sense of smell (hyposmia) or taste.
- Headache: Often described as a pressure headache.
- Sore throat.
- Cough: May be worse at night.
- Fatigue.
- Fever: More common with acute bacterial sinusitis.
- Bad breath (halitosis).
- Ear pressure or fullness.
- Medical history and physical exam: The doctor will ask about your symptoms, their duration, and any relevant medical conditions. They will examine your nose and face, looking for redness, swelling, or tenderness.
- Nasal endoscopy: A thin, flexible, lighted tube (endoscope) may be inserted into the nose to visualize the nasal passages and sinus openings for inflammation, polyps, or pus.
- Imaging tests:
- CT scan of the sinuses: Provides detailed images of the sinuses and can identify blockages, inflammation, or structural abnormalities. This is often used for chronic or recurrent sinusitis.
- X-rays: Less commonly used for sinusitis diagnosis but may be considered.
- Cultures: Nasal or sinus cultures may be taken to identify the specific bacteria or fungi causing the infection, especially if the infection is severe, persistent, or not responding to treatment.
- Allergy testing: If allergies are suspected as an underlying cause.
- For Acute Viral Sinusitis:
- Symptom relief: Rest, fluids, saline nasal sprays or rinses, over-the-counter pain relievers (e.g., ibuprofen, acetaminophen), and decongestants. Antibiotics are not effective for viral infections.
- For Acute Bacterial Sinusitis:
- Antibiotics: Prescribed if symptoms are severe, worsening, or persist beyond 7-10 days.
- Nasal corticosteroids: Reduce inflammation and help clear blockages.
- Saline nasal rinses: Help clear mucus.
- For Chronic Sinusitis:
- Nasal corticosteroids: Often a long-term treatment to reduce inflammation.
- Saline nasal rinses: Daily use to clear mucus and irritants.
- Antibiotics: May be used for longer durations (e.g., 3-4 weeks) or in low doses for their anti-inflammatory effects.
- Oral corticosteroids: Short courses may be used for severe inflammation.
- Antifungal medications: If a fungal infection is identified.
- Biologic drugs: For severe chronic sinusitis with nasal polyps that doesn't respond to other treatments.
- Surgery (Endoscopic Sinus Surgery): Considered when medical treatments are ineffective, especially if there are structural blockages like polyps or a deviated septum. Surgery aims to open and enlarge the sinus drainage pathways.
- For Allergic Sinusitis:
- Allergy management: Allergen avoidance, antihistamines, nasal corticosteroids, and potentially allergen immunotherapy.