What is Sinusitis?

Sinusitis: An Overview

If you have nasal congestion that just won’t go away, aggravating pain around the eyes, forehead and cheeks, dental pain, headaches and fever, and feel constantly tired, you may have sinusitis. Sinusitis, also known as rhinosinusitis, means your sinuses are inflamed.

Your sinuses are the hollow, air-filled cavities within your skull. A thin layer of mucus and tiny hairs in the sinuses, called cilia, help trap bacteria and other particles you breathe in and move those particles and bacteria out through your nose. If the lining of your sinuses becomes inflamed, the sinuses will not drain properly. Inflammation can happen when you have a cold, if you have allergies or are exposed to environmental pollution, or if your nasal passages are blocked and cause a backup of mucus into your sinuses.

Sinusitis can affect any of the sinuses – including the maxillary sinuses behind the cheekbones, frontal sinuses behind the forehead, ethmoid sinuses between the eyes, and sphenoid sinuses in bones behind the nose.

The Sinuses

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Quick Facts on Sinusitis

What causes sinusitis?

A cold is the most common cause of acute sinusitis. Sinusitis can also be caused by allergies, a deviated septum, growths called nasal polyps, and certain health conditions that affect the immune system (like HIV) or mucus thickness (like cystic fibrosis).

What does sinusitis look like?

Your sinus doctor may recommend you have an imaging test done called a CT scan. This scan will show thickened sinus linings, polyps or other obstructions blocking the nasal passage. Your sinus doctor may also do an endoscopic sinus exam. The endoscope is a small, thin, rigid or flexible tube with a light on one end and an eyepiece or camera attached to a computer on the other end. The endoscope provides a detailed picture of the nasal and sinus cavities and can show if swelling and/or redness is present, nasal passages are blocked or abnormally shaped, thick or discolored mucus is draining from a sinus opening, or if polyps or a deviated septum are present.

What is the typical sinusitis recovery time?

Anyone with the condition wants to know how long sinusitis will last. Acute sinusitis typically resolves within four weeks. Subacute sinusitis can last up to 12 weeks. Chronic sinusitis is sinus inflammation and improper drainage lasting 12 weeks or more. Sinusitis treatment is typically needed to reduce or relieve symptoms associated with chronic or recurrent sinusitis.

Is sinusitis contagious?

While the original infection that causes acute sinusitis – typically a common cold virus – is contagious, sinusitis itself is not.

What are the different types of sinusitis?

There are several sinusitis types and your diagnosis will depend on how long sinus symptoms have been present and the cause of the inflammation.

The Facts on Sinusitis

According to the Centers for Disease Control and Prevention National Center for Health Statistics, 29.4 million adults in the United States – about 12 percent of the population – have been diagnosed with sinusitis. The American Rhinologic Society puts that number closer to 30 million people each year.

It’s clear that sinusitis is one of the most common chronic illnesses in America. And, according to findings from a July 2014 Qualtrics survey:

• 33 percent of sinusitis sufferers are spending $250-$1,000 annually on over-the-counter treatments, physician consultations, and copays to treat their symptoms
• 34 percent feel their work activities and performance have been significantly impacted, with many missing days of work
• More than 35 percent note their leisure activities have been negatively impacted
• 36 percent say their sex life has also suffered

Sinusitis Symptoms

Have you felt stuffed up for ages, unable to breathe comfortably during the day or while you’re trying to get some sleep? Have a headache and pressure in your face that just won’t quit? If these symptoms have been around a while, you may have sinusitis. While acute sinusitis – which commonly follows a cold – can cause these symptoms, they’re typically short-lived. If you’ve been dealing with sinus misery for several weeks, or experience more than a few episodes a year, you could have chronic or recurrent acute sinusitis – conditions that require treatment if you want relief.

While some people have symptoms that are constant, severe, and significantly disruptive to their lives, others may have symptoms that come and go, disappear for a while and then return, or tend to be annoying rather than severe.

How can I manage symptoms at home?

If symptoms are moderate or have recently appeared, applying hot compresses to the face, inhaling steam, irrigating the nose with saline drops or spray, and taking over-the-counter sinusitis medication like decongestants and pain-relivers (acetaminophen, NSAIDs) can help treat pain, pressure, and congestion. If these symptoms have lasted weeks or keep coming back, you have a high fever or persistent headache, or simple remedies don’t bring relief – you should see your sinus doctor.

Sinusitis Risk Factors and Complications

There are certain factors that can put you at a higher risk of developing chronic or recurrent acute sinusitis, some of which may respond to treatment or lifestyle changes. Talk to your sinus doctor about treating or managing these factors.

Risk Factors for Chronic or Recurrent Sinusitis

• Structural abnormalities in the nasal passage, like a deviated septum or nasal polyps
• Asthma (common with moderate-to-severe cases)
• Allergies
• Aspirin sensitivity, sometimes accompanied by nasal polyps
• Immune system disorders, like HIV/AIDS
• Cystic fibrosis, due to abnormally thick mucus
• Regular exposure to cigarette smoke or pollutants
• Pregnancy, which can cause blood vessels and membranes in the nose to swell even without infection or allergy

While rare, chronic or recurrent acute sinusitis can lead to some serious complications which are typically caused by infection. While acute sinusitis is usually caused by a virus and will resolve on its own or with home remedies, chronic or recurrent sinusitis should be treated to avoid more severe infection or sinus damage.

Possible Complications of Sinusitis

Sinusitis Treatment

If you have acute sinusitis, which is most often caused by a viral infection, your sinus doctor will recommend home remedies and over-the-counter or prescription sinusitis medications to ease your symptoms. You may find relief through a combination of administering saline nasal drops or sprays, breathing in steam or applying hot facial compresses, and taking over-the-counter or prescription decongestants, pain relievers, and/or corticosteroids.

However, if you’re dealing with chronic sinusitis – or recurrent acute sinusitis – home remedies may only be a temporary fix. And, some people find their chronic or recurring sinusitis doesn’t respond, or stops responding, to decongestants, nasal and systemic steroids, mucolytics (to reduce thickened nasal secretions), and pain relievers such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs).

Even if medications are effective, frequently taking multiple rounds of drugs just to keep symptoms in check can impact your quality of life.

When should I see my doctor?

If you’ve just developed sinusitis symptoms, you can try home remedies and over-the-counter treatments to find relief. But you should call a doctor if you experience any of the following: symptoms get worse after a few days; persistent fever; or recurring or long-lasting sinus symptoms. 

When is it time to consider sinus surgery?

If your sinus doctor has diagnosed you with chronic or recurrent acute sinusitis, your symptoms haven’t improved with medications after several weeks, or a CT scan of your sinuses shows nasal polyps, a severely deviated septum, or another structural problem preventing sinus drainage, you may need to consider sinus surgery. 

Is there an alternative to surgery?

For some patients with chronic or acute recurrent sinusitis, a minimally invasive procedure called balloon sinus dilation can provide immediate and long-lasting relief. Performed under local anesthesia in your sinus doctor’s office, the procedure involves gentle inflation of a balloon to expand the sinus opening and promote drainage. Recovery is fast – with patients returning to normal activity in one to two days.

Medical Sinusitis Treatments

Your sinusitis treatment will depend on the severity of your symptoms and how long they’ve been present; if they’re caused or worsened by infection, allergies, or structural problems; and what approaches you’ve tried and how they’ve worked.

Treatments can include:

• Saline nasal irrigation
• Allergy shots (when appropriate)
• Medication therapy
• Functional endoscopic sinus surgery (FESS)
• Balloon sinus dilation (adult and pediatric)