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Acute sinusitis

Sinusitis is inflammation of the linings of the sinuses that surround the nose. Common symptoms include a tender face and a blocked nose. It's often caused by an infection.

About sinusitis

What are sinuses?

The sinuses are air-filled spaces behind the bones of your face that open up into the nose cavity. They are lined with the same membrane as your nose. This is called the mucous membrane and it produces a slimy secretion called mucus to keep the nasal passageways moist and to trap dirt particles and bacteria.

You have four main sets of sinuses.

  • The maxillary sinuses are in each cheekbone
  • The frontal sinuses are on either side of your forehead, above your eyes
  • The smaller ethmoid sinuses are behind the bridge of your nose, between your eyes
  • The sphenoid sinuses are between the upper part of your nose and behind your eyes

The maxillary sinuses are the largest of the sinuses and the ones most commonly affected by sinusitis.

What is sinusitis?

Sinusitis is inflammation of the mucous membranes of one or more of your sinuses.

If your sinusitis lasts anything from a few days up to a month it's called acute sinusitis. If your sinusitis is an ongoing problem lasting three months or more you may have chronic sinusitis (see Related topics). The medical terms acute and chronic refer to how long the condition lasts for, rather than how severe it is.

Acute sinusitis is common and can affect people of any age.

Symptoms

If you have sinusitis you may feel generally unwell and have a blocked nose. Sometimes people think they have a common cold when they have sinusitis. If you have sinusitis, your symptoms may include:

  • pain and pressure in your face, which is worse when you lean forwards
  • a blocked nose with green or yellow mucus, which can drain down the back of your nose into your throat and may cause a sore throat and cough
  • a headache when you wake in the morning
  • a fever
  • earache
  • toothache or pain in your upper jaw

The pain you have will depend on which of your sinuses are affected.

  • Frontal sinusitis can cause pain just above your eyebrows, and your forehead may be tender to touch.
  • Maxillary sinusitis can cause your upper jaw, teeth and cheeks to ache and may be mistaken for toothache.
  • Ethmoid sinusitis can cause pain around your eyes and the sides of your nose.
  • Sphenoid sinusitis can cause pain around your eyes, at the top of your head or in your temples. You may also have earache and neck pain.

On very rare occasions, a sinus infection can spread to the bones of the face or the membranes lining the brain. Also very rarely, sinusitis can spread to form a pocket of pus (abscess) in the eye socket, the brain or a facial bone. If you develop swollen eyelids while you have sinusitis you should see your GP immediately.

Causes

Acute sinusitis is caused by an infection of the mucous membranes with a virus, bacterium or fungus. Most people with sinusitis have a viral infection such as the common cold.

The mucus that is produced by the mucous membranes in your sinuses normally drains into your nose through small holes called ostia. The ostia can become narrow or even blocked if the sinuses get infected and inflamed so the mucus cannot drain properly.

This can also happen if your membranes are irritated by something. Examples of irritants include:

  • airborne allergens such as grass and tree pollen
  • smoke and air pollution
  • sprays containing chemicals (eg household detergents)
  • nasal decongestants, if overused
  • chronic drug misuse (snorting substances such as cocaine)

Diagnosis

Your GP will ask you about your symptoms and will examine you. He or she may also ask you about your previous illnesses and operations.

Your GP will usually be able to diagnose your sinusitis just from examining you and no further medical tests are usually necessary.

Treatment

Most people with acute sinusitis get better without treatment. However, you may find that home treatments and over-the-counter medicines provide some relief.

Some people find that breathing in steam from a bowl of hot (but not boiling) water containing a few drops of menthol oil (eg Olbas oil or Karvol) provides some relief from the symptoms. However, this isn't scientifically proven. Another method is to sit in the bathroom with the hot shower running and inhale steam this way. Some people find that applying a warm compress on the areas of the face that are painful and sleeping with their head and shoulders propped up with pillows provides relief but again there is no scientific evidence that this works.

You can take the painkiller you usually take for a headache to relieve pain and lower your temperature if you have a fever.

Decongestant tablets, such as pseudoephedrine (eg Sudafed), may reduce swelling in your nose and allow your sinuses to drain. Decongestant nasal sprays are also available but you should not use them for more than a week, as prolonged use can actually make nasal blockage worse in the long run. Always read the patient information leaflet that comes with your medicine and ask your pharmacist or doctor for advice.

If your symptoms continue for more than a week you may wish to see your GP. If the sinusitis is thought to have been caused by a bacterial infection, your GP may prescribe antibiotics.

Prevention

There are a number of things you can do to help prevent sinusitis developing such as:

  • taking a short course (usually no longer than seven days) of decongestant medicine when you have a cold
  • having a flu vaccination each year
  • staying well hydrated by drinking plenty of fluids
  • not smoking
  • staying away from smoky environments
  • keeping your allergy symptoms under control - ask your doctor or pharmacist for advice
  • maintaining good general health by eating healthily and taking regular exercise

Further information

The British Association of Otorhinolaryngologists (ENT-UK)

Sources

  • About Sinusitis. ENT-UK. www.entuk.org, accessed 24 May 2007
  • Patient information rhino sinusitis in children. ENT-UK. www.entuk.org, accessed 24 May 2007
  • Sinusitis. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 23 May 2007
  • Ah-See K, Evans AS. Sinusitis and its management. BMJ 2007; 334:358-361
  • Collier J, Longmore M, Scally, P. Oxford Handbook of Clinical Specialities. 6th ed. Oxford: Oxford University Press, 2003
  • Sinusitis. National Institute of Allergy and Infectious Diseases, National Institute of Health, US department of health and human services. www.niaid.nih.gov, accessed 23 May 2007
  • Scottish Advisory Committee on Drug Misuse: Psychostimulant Working Group Report. Scottish Executive, Substance Misuse Division, 2002. www.scotland.gov.uk, accessed 5 June 2007
  • British Medical Association. British National Formulary 53 March 2007. London: BMJ Publishing Group Ltd, RPS Publishing, 2007

 

Related topics

Chronic sinusitis

Sinusitis in children