Sinusitis is a common inflammation of the paranasal sinuses, the cavities that produce the mucus necessary for the nasal passages to work effectively.

It can be acute or chronic, and it can be caused by viruses, bacteria, fungi, allergies, or even an autoimmune reaction.

Although uncomfortable and painful, sinusitis often goes away without medical intervention. However, if symptoms last more than 7 to 10 days, or if there is a fever or a bad headache, you should see your doctor.

In 2015, the Centers for Disease Control and Prevention (CDC) noted that 12.1 percent of adults surveyed in the United States (U.S.) had been diagnosed with sinusitis in the previous 12 months.

Fast facts on sinusitis

Here are some key points about sinusitis. More detail is in the main article.

  • People have four pairs of sinuses, hollow spaces behind the bones of the face.
  • Allergies, bacteria or a virus can cause inflammation of the sinuses, or sinusitis.
  • It usually goes away without treatment, but sometimes medical attention is needed.
  • Chronic sinusitis lasts more than 12 weeks.

A sinus is a hollow space in the body. There are many types of sinus, but sinusitis affects the paranasal sinuses, the spaces behind the face that lead to the nasal cavity.

The paranasal sinuses have the same mucous membrane lining as the nose.They produce a slimy secretion called mucus. This keeps the nasal passages moist and traps dirt particles and germs.

Sinusitis occurs when mucus builds up and the sinuses become inflamed.

Doctors often refer to sinusitis as rhinosinusitus, because inflammation of the sinuses nearly always occurs with inflammation of the nose known as rhinitis.

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Sinus infections or sinusitis may be caused by anything that interferes with airflow into the sinuses and the drainage of mucus out of the sinuses. The sinus openings (ostea) may be blocked by swelling of the tissue lining and adjacent nasal passage tissue, for example with

  • common colds,
  • allergies, and
  • tissue irritants such as OTC nasal sprays, cocaine, and cigarette smoke.

Other causes of sinus infections or sinusitis

Tumors or growths also can block the sinuses if they are near the sinus openings.

Dehydration, disease, drying medications, and lack of sufficient humidity can cause sinusitis or sinus infection.The drainage of mucous from the sinuses can also be impaired by thickening of the mucous secretions, by decrease in hydration (water content) of the mucous brought on by disease (for example, cystic fibrosis), drying medications (antihistamines), and lack of sufficient humidity in the air. The epithelial cells have small hair-like fibers, called cilia, which move back and forth to help the mucus move out of the sinuses. These small cilia may be damaged by many irritants, especially smoke. This can prevent them from assisting the mucus in draining from the sinuses, and thus results in sinus infections or sinusitis.

Stagnated mucus provides an environment for bacteria, viruses and in some circumstances, (for example, AIDS or immunodepressed people) fungus, to grow within the sinus cavities. In addition, the microbes themselves can initiate and exacerbate sinus blockage. The most commonly infected sinuses are the maxillary and ethmoid sinuses.

Rarely, immunodepressed or victims of multiple traumas in disasters such as tsunamis, hurricanes, earthquakes, or tornadoes may breathe in fungi from the soil or water. Eventually, in a few days to over a week, the fungi can grow and cut off blood supply to almost any type of tissue, especially in the nose and eyes. These infections, although rare, are serious and can be deadly and require immediate medical and surgical care. Although the fungal infection may resemble common bacterial sinusitis initially, it is a disease termed zygomycosis or mucormycosis.

The following may increase a person's risk of developing sinusitis:

  • previous respiratory tract infections, such as the common cold
  • nasal polyps, or small growths in the nasal passage that can lead to inflammation
  • weakened immunity, due, for example, to a health condition or some kinds of treatment
  • an allergic reaction to substances such as dust, pollen, and animal hair
  • structural problems in the nose, for example, a deviated septum

The septum is the bone and cartilage that divides the nose into two nostrils. When this is bent to one side, either through injury or growth, it can lead to repeated infections and inflammation.

Symptoms vary, depending on the length and severity of the infection.

If the patient has two or more of the following symptoms and thick, green or yellow nasal discharge, they may be diagnosed with acute sinusitis.

  • facial pain and pressure
  • blocked nose
  • nasal discharge
  • reduced sense of smell
  • congestion
  • cough

In more advanced cases, the following symptoms may also be present:

  • fever
  • halitosis, or foul-smelling breath
  • tiredness
  • toothache
  • headache

If these symptoms continue for 12 weeks or longer, the doctor may diagnose chronic sinusitis.

A doctor will carry out a physical examination and ask the patient about their symptoms. This is usually enough to make a diagnosis.

The doctor may visually examine the nasal cavity with a light source, or a small, handheld device with a light attached called an otoscope, which can also be used to examine the ears.

If symptoms persist, a doctor may refer a person with sinusitis to an ear, nose, and throat specialist (ENT) for a more in-depth examination. They may insert an endoscope into the nose, a small, thin, flexible tube with a light and camera attached. This can provide more detailed images.

In cases of persistent or severe sinusitis, a CT scan may be needed.

Treatment options depend on how long the condition lasts.

Acute and subacute sinusitis

Most acute cases will resolve without treatment.

However, sinusitis can be uncomfortable, so people often use home remedies and over-the-counter (OTC) medications to relieve symptoms.

In the following cases, the person should see a doctor:

  • Symptoms persist longer than 7 to 10 days.
  • There is a fever higher than 101.5° Fahrenheit, or around 38.6° Celsius.
  • There is a bad headache that does not resolve with over-the-counter (OTC) drugs.
  • Visual disturbances occur, or there is swelling around the eyes.
  • Symptoms continue after taking antibiotics prescribed by a physician.

If the sinusitis has a bacterial cause, a doctor may prescribe antibiotics. If symptoms remain after the course of medication is finished, the individual should return to the doctor.

Chronic sinusitis

Chronic sinusitis is not usually bacterial in nature, so antibiotics are unlikely to resolve symptoms. A fungal infection can be treated with antifungal drugs.

Corticosteroid sprays can help in recurrent cases, but these need a prescription and medical supervision.

In allergic sinusitis, treating allergies with shots or reducing and avoiding exposure to allergens like animal dander or mold can lessen the occurrence of chronic sinusitis.


Structural issues, such as a deviated septum, may need surgery. Surgery may also be advised if there are polyps, or if the sinusitis has resisted all other treatments.

Functional endoscopic sinus surgery (FESS) is the main procedure used for treatment, but other surgeries may be required as other parts of the nose are often affected. If a deviated septum is causing recurrent infections, for example, a septoplasty will be used to straighten out this bone and cartilage.

Treatment may still be required following surgery to prevent the return of sinusitis.

Surgery should always be the last resort on sinusitis in children, and obtaining a second opinion is recommended before proceeding.

Insurers may require patients to provide in-depth evidence to ensure that the surgery is for sinusitis and not for cosmetic surgery, to improve the appearance of the nose.

The following may help prevent sinusitis:

  • Practice good hand hygiene.
  • Avoid smoking and second-hand smoke.
  • Keep vaccinations up to date.
  • Stay away from people with colds and other respiratory infections.
  • Use a humidifier to moisten the air at home, and keep it clean. A selection of humidifiers is available for purchase online.
  • Maintain air conditioning units to prevent mold and dust from collecting.
  • Where possible, avoid allergens.

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