What is sinusitis?

Sinusitis is a condition in which the membrane lining of a sinus, particularly the paranasal sinuses, becomes inflamed. Acute sinusitis is a temporary condition that can be treated with antibiotics and decongestants. Chronic sinusitis is a condition in which there are at least four recurrences of acute sinusitis and can be treated with either medication or surgery.

Is sinusitis common?
Each year, more than 37 million Americans suffer from at least one episode of acute sinusitis. Increased pollution, urban sprawl and increased antibiotic resistance is partially to blame for the increase in sinusitis over the last decade.

What are the symptoms of acute sinusitis?
Symptoms of acute sinusitis may include bad breath, cough, dental pain, diminished sense of smell, facial pain/pressure, fatigue, fever, nasal discharge, and nasal obstruction. Diagnosis may be made when patients have two or more symptoms and/or a thick, green or yellow nasal discharge. Acute sinusitis may last for four or more weeks. In cases where symptoms worsen after five days, persist after ten days or are more severe than those associated with a normal viral infection, an acute bacterial infection may be present.

How do you treat acute sinusitis?
Antibiotics are typically prescribed for ten to fourteen days to treat acute sinusitis. In addition, decongestants may be recommended.

What are the symptoms of chronic sinusitis?
The symptoms of chronic sinusitis may include bad breath, facial congestion/fullness, facial pain/pressure, fatigue, fever, headache, nasal obstruction/ blockage, thick nasal discharge/ discolored post-nasal drainage, and pus in the nasal cavity. Symptoms may last for twelve or more weeks.

Are there any at-home treatments that can help relieve sinus pain?
Warm moist air produced by a vaporizer or a pan of boiling water can help to alleviate sinus congestions. Pain in the nose and sinuses can also be relieved with warm compresses. Saline nose drops may also be helpful.

Are non-prescription nose drops or sprays effective?
Non-prescription nose drops or sprays can help to control symptoms but they should not be used for longer than their label recommendation.

How is the best treatment for acute or chronic sinusitis determined?
A physician will asses a patient's history and symptoms and conduct a physical exam in order to determine the best treatment for the particular patient.

What happens during a physical exam for sinusitis?
When sinusitis is suspected, patients may receive a thorough ear, nose and throat examination from a specialist in which the facial features will be explored, particularly areas where swelling and redness of the skin occur over the cheekbone. Swelling and redness in the face is often worse in the morning and the gradually improves as the patient remains upright. The sinuses may be felt and pressed by the physician for tenderness, and the teeth may be tapped to help determine if an inflamed paranasal sinus is present.

Are there any other diagnostic procedures that may be used to diagnose sinusitis?
In order to diagnose sinusitis, diagnostic tests such as allergy testing, CT scan, an endoscopy, mucus culture study, and x-rays may be taken.

What is nasal endoscopy?
Nasal endoscopy is a procedure which allows for visual examination of the nose and sinus drainage areas through the use of an endoscope, a special fiber optic instrument designed for the examination of the interior of a canal or hollow viscus.

Why might a physician perform a nasal endoscopy?
Nasal endoscopy is a good way for a physician to get a reliable visual view of all the accessible areas of the sinus drainage pathways. For the procedure, the patient's nasal cavity is anesthetized and then a rigid or flexible endoscope is placed in a position enabling a view of the nasal cavity. Signs of obstruction and nasal polyps which may be hidden from routine nasal examination can be observed through nasal endoscopy, along with pus and structural abnormalities that may lead to recurrent sinusitis.

What treatment is usually recommended?
Nasal sprays, nose drops or oral decongestants may be recommended to help reduce congestion. Bacterial infections founds in the sinuses are treated with antibiotics, whereas antihistamines may be used for the treatment of allergies. Fungal infections are typically treated with antifungal medication.

Are there lifestyle changes that are part of treatment?
During sinus problems, it's important that patients who smoke refrain from doing so. In addition, the mucus can help to be thinned by drinking extra fluids.

When is sinus surgery used for treatment?
Sinus surgery may be required when antibiotic treatment is not effective.

What can I expect from sinus surgery?
Endoscopic sinus surgery is typically performed with either local or general anesthesia. Though full recovery after surgery takes about four weeks, patients are typically able to return to their normal activities within about four days.

What is the point of sinus surgery?
The goal of sinus surgery is to enlarge the natural openings of the sinuses while leaving as many of the cilia as possible in place. Endoscopic surgery tends to be most effective in restoring normal sinus function as it can remove areas of obstruction and restore normal flow of mucus.

What can happen if infected sinuses are not treated?
Unnecessary pain and discomfort can result if sinusitis is left untreated. Though rare, failure to treat sinusitis may also result in meningitis or brain abscess and infection of the bone or bone marrow.

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