Acute Sinusitis
overview
Although sinuses appear to be hollow spaces, they are actually a well-integrated system that connects to the nose through narrow channels. The sinus cavities are lined with specially designed microscopic cells called cilia. They help keep the channels open by allowing air into the cavities and promoting drainage of mucus into the nose. Healthy sinuses are free from bacteria, viruses, and allergens. Sinuses that become inflamed or infected soon become blocked and can make life miserable on a seasonal basis or chronically.
Acute Sinusitis
overview
Although sinuses appear to be hollow spaces, they are actually a well-integrated system that connects to the nose through narrow channels. The sinus cavities are lined with specially designed microscopic cells called cilia. They help keep the channels open by allowing air into the cavities and promoting drainage of mucus into the nose. Healthy sinuses are free from bacteria, viruses, and allergens. Sinuses that become inflamed or infected soon become blocked and can make life miserable on a seasonal basis or chronically.
Where are my sinuses?
There are four paired sinus cavities in the face:
1. Ethmoid
2. Frontal
3. Sphenoid
4. Maxillary
Sinusitis is a term used to describe inflammation of the sinus linings. This condition is most often the result of repeated bacterial or viral infections, allergies, or anatomic problems such as blocked sinus openings, deviated nasal septum, and/or nasal polyps. The sinuses normally drain through small openings, called ostia, in the nose. Anything that obstructs that flow can cause a buildup of mucus, and sometimes pus, in the sinuses. These openings can be blocked simply by anatomical variations between individuals, or by inflammation caused by frequent infections and/or seasonal allergies.
Where are my sinuses?
There are four paired sinus cavities in the face:
1. Frontal
2. Maxillary
3. Ethmoid
4. Sphenoid
Sinusitis is a term used to describe inflammation of the sinus linings. This condition is most often the result of repeated bacterial or viral infections, allergies, or anatomic problems such as blocked sinus openings, deviated nasal septum, and/or nasal polyps. The sinuses normally drain through small openings, called ostia, in the nose. Anything that obstructs that flow can cause a buildup of mucus, and sometimes pus, in the sinuses. These openings can be blocked simply by anatomical variations between individuals, or by inflammation caused by frequent infections and/or seasonal allergies.
Symptoms
Acute sinusitis is when a patient has the following symptoms for less than one month:
- Cloudy or colored drainage from the nose or down the back of the throat AND
- Difficulty breathing through the nose AND/OR
- Facial pain or pressure
Causes
Most sinus infections are caused by viruses and last less than 10 days. Symptoms lasting more than 10 days, or if you experience improvement in your symptoms followed by worsening of your symptoms again, is a sign of a bacterial infection. Sinusitis can also be triggered by nasal polyps, and in rare circumstances, funguses.
Symptoms
Acute sinusitis is when a patient has the following symptoms for less than one month:
- Cloudy or colored drainage from the nose or down the back of the throat AND
- Difficulty breathing through the nose AND/OR
- Facial pain or pressure
Causes
Most sinus infections are caused by viruses and last less than 10 days. Symptoms lasting more than 10 days, or if you experience improvement in your symptoms followed by worsening of your symptoms again, is a sign of a bacterial infection. Sinusitis can also be triggered by nasal polyps, and in rare circumstances, funguses.
Diagnosis
Diagnosis is made from both history and physical exam. Visualization of cloudy or colored nasal drainage on the exam, associated with patient symptoms of nasal blockage or facial pressure would confirm the diagnosis. Other potential methods to make a diagnosis include:
Nasal Endoscopy
Not all nasal discharge is seen when examining the front of the nose. Often, a camera is placed in the nose to visualize if colored mucous is seen draining from the nasal sinuses.
Nasal Culture
Patients with persistent sinusitis that is not responding to treatment may have a culture taken from the nose. This allows for the identification of the type of bacteria causing the infection and which antibiotics would be most effective in treating the infection.
CT Scan
This is a type of X-ray of the sinus that is normally not performed for acute sinusitis. Indications for obtaining a CT scan with an acute infection include facial swelling, swelling around the eye, changes in vision, signs of meningitis along with sinusitis.
Allergy Testing
Patients that have recurrent sinus infections, along with allergy symptoms, are often allergy tested to identify the type of environmental allergens that may be triggering their symptoms. Allergens cause inflammation of the nasal passageways that can lead to sinus infections.
Diagnosis
Diagnosis is made from both history and physical exam. Visualization of cloudy or colored nasal drainage on the exam, associated with patient symptoms of nasal blockage or facial pressure would confirm the diagnosis. Other potential methods to make a diagnosis include:
Nasal Endoscopy
Not all nasal discharge is seen when examining the front of the nose. Often, a camera is placed in the nose to visualize if colored mucous is seen draining from the nasal sinuses.
Nasal Culture
Patients with persistent sinusitis that is not responding to treatment may have a culture taken from the nose. This allows for the identification of the type of bacteria causing the infection and which antibiotics would be most effective in treating the infection.
CT Scan
This is a type of X-ray of the sinus that is normally not performed for acute sinusitis. Indications for obtaining a CT scan with an acute infection include facial swelling, swelling around the eye, changes in vision, signs of meningitis along with sinusitis.
Allergy Testing
Patients that have recurrent sinus infections, along with allergy symptoms, are often allergy tested to identify the type of environmental allergens that may be triggering their symptoms. Allergens cause inflammation of the nasal passageways that can lead to sinus infections.
Available Treatments
Viral Sinusitis
- Analgesics: acetaminophen (Tylenol) and ibuprofen (Motrin) are typically sufficient for pain or fever control.
- Intranasal steroid: fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort), triamcinolone (Nasacort), beclomethasone (QNasl) are several examples. Intranasal steroid sprays have been shown to help reduce facial pain and nasal congestion.
- Nasal saline: helps to thin mucous and clear debris from the nose.
- Decongestants: a decongestant nose spray, such as oxymetazoline (Afrin), can provide symptomatic relief but should not be used longer than 3 days in a row due to rebound congestion that can occur if taken for longer. Oral decongestants can also provide relief but should be avoided in patients with high blood pressure or heart conditions.
Bacterial Sinusitis
- All of the above treatments for viral sinusitis +
- Antibiotics: typically prescribed for 5-10 days for an acute infection. If symptoms do not improve or are not completely resolved after 10 days, the type of antibiotic may be switched or the same antibiotic may be given for another 10 days.
Recurrent Sinusitis
- Balloon Sinuplasty: patients with 4 or more episodes of sinusitis a year are candidates for in-office balloon sinuplasty. This is a procedure that enlarges the natural drainage pathway of your sinuses, leading to less sinus infections in the future.
Treatment
Viral Sinusitis
- Analgesics: acetaminophen (Tylenol) and ibuprofen (Motrin) are typically sufficient for pain or fever control.
- Intranasal steroid: fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort), triamcinolone (Nasacort), beclomethasone (QNasl) are several examples. Intranasal steroid sprays have been shown to help reduce facial pain and nasal congestion.
- Nasal saline: helps to thin mucous and clear debris from the nose.
- Decongestants: a decongestant nose spray, such as oxymetazoline (Afrin), can provide symptomatic relief but should not be used longer than 3 days in a row due to rebound congestion that can occur if taken for longer. Oral decongestants can also provide relief, but should be avoided in patients with high blood pressure or heart conditions.
Bacterial Sinusitis
- All of the above treatments for viral sinusitis +
- Antibiotics: typically prescribed for 5-10 days for an acute infection. If symptoms do not improve or are not completely resolved after 10 days, the type of antibiotic may be switched or the same antibiotic may be given for another 10 days.
Recurrent Sinusitis
- Balloon Sinuplasty: patients with 4 or more episodes of sinusitis a year are candidates for in-office balloon sinuplasty. This is a procedure that enlarges the natural drainage pathway of your sinuses, leading to less sinus infections in the future.
Services We Provide
- Treatment of acute and chronic sinusitis
- Nasal endoscopy
- In-office CT scan
- Allergy testing and treatment
- Nasal culture when indicated
- In-office balloon sinuplasty
Services We Provide
- Treatment of acute and chronic sinusitis
- Nasal endoscopy
- In-office CT scan
- Allergy testing and treatment
- Nasal culture when indicated
- In-office balloon sinuplasty