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    Sinusitis Slideshow: Symptoms, Diagnosis, Treatment

    Sinus Attack!

    Pain in the forehead or between the eyes? Upper teeth ache? Face feeling full, nose stuffy and congested? You may have a common complaint that sends many people to a doctor's office: sinus trouble.

    What Are Sinuses?

    What Are Sinuses?

    They’re air spaces in your skull lined with mucous membranes. Most people have four sets of nasal sinuses:

    • Two in the forehead above the eyes
    • One inside each cheekbone (dark triangles seen in this image)
    • A group of them, called the ethmoid sinuses, behind the bridge of the nose
    • Another group behind the nose and underneath the brain called the sphenoid sinuses

    Sinuses are like fingerprints: Everybody's are different.  Some people have no frontal sinuses or just one.

    What Is Sinusitis?

    It’s inflammation in your sinuses. Tiny, hair-like structures called cilia (magnified here) move mucus across sinus membranes and toward an exit. All of your sinus cavities connect to your nose to allow a free exchange of air and mucus. Infections or allergies make sinus tissues inflamed, red, and swollen.

    Just a Cold … at First

    Sinusitis usually starts with inflammation triggered by a cold, allergy attack, or irritant. But it may not end there. Colds, allergies, and irritants make sinus tissues swell.

    How It Feels

    Most people have a stuffy nose and pain or pressure in several areas around the face or teeth. There's usually a nasal discharge that may be yellow, green, or clear. You may also have fatigue, trouble with sense of smell or taste, cough, sore throat, bad breath, headache, pain when you bend forward, and fever.

    When It Won't Go Away

    Inflammation of the sinuses that lasts for more than 3 months is chronic sinusitis. Bacteria can make their home in blocked sinuses, but they aren’t the only cause. Anatomy, allergies, polyps, immune system problems, and dental diseases may also be to blame.

    Nasal Polyps

    If your sinuses remain inflamed, sinus membranes can thicken and swell. The swelling may be enough to cause grape-like masses called polyps (shown here). They can jut out from the sinus into the nasal passage and block your nasal airway.

    Nasal Decongestants

    These sprays open swollen nasal passages and allow your sinuses to drain. But you should use these drugs only for a few days. After that, there's a kickback effect, making your nasal passages swell shut again. Nasal steroid sprays, or saline sprays or washes, may be other options. If symptoms don’t stop, see your doctor.

    Do You Need Antibiotics?

    The common cold is a viral infection. Colds can lead to sinusitis symptoms, but these usually clear by themselves. Antibiotics don’t treat viruses, so they won't help the sinus symptoms of a cold. Your cold should be over in a week or two. Usually, cold-related sinusitis goes away then, too.

    Treating Allergy-Related Sinusitis

    Have you tried irrigation with saline solution, either with a neti pot or squeeze bottle? Nasal steroid sprays might help, too, if your sinus symptoms are due to allergies. Antihistamines could also come in handy, especially if you’re sneezing and have a runny nose.

    When to See the Doctor

    Yellow or green mucus can mean a bacterial infection. Even then, it usually clears up in 7 to 14 days without antibiotics. But if you keep feeling worse, your symptoms last and are severe, or if you get a fever, it's time to see a doctor.

    Will You Need Sinus Surgery?

    An operation called FESS (functional endoscopic sinus surgery) can bring some relief, if nothing else works. But start with the simplest solution: Avoid things that irritate your sinuses, and then work with your doctor to see if medicines help. Surgery is the last resort.

    Rare Complications

    Only a layer of bone separates your sinuses from your brain. It’s not likely, but if a sinus infection passes through the bone, it can infect the lining of the brain or the brain itself. It’s also uncommon, but a sinus infection could spread into the eye socket, causing an infection that could cause blindness. Less severe complications include asthma attacks and loss of smell or taste, which are usually temporary.

    Can You Prevent Sinusitis?

    Unfortunately, no. But you can do these three things that help:

    • Keep your sinuses moist. Use saline sprays, nasal lubricant sprays, or nasal irrigation often.
    • Avoid very dry indoor environments.
    • Avoid exposure to irritants, such as cigarette smoke or strong chemical odors.

     

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    What Is Sinusitis?

    (continued)

    What Is Nasal Endoscopy?

    A nasal endoscope is a tubelike instrument equipped with tiny lights and cameras. Doctors use it to see inside your nose and sinus drainage areas.

    You may get a "local," which numbs the area, but that’s not always needed.

    Treatment

    If you have a simple sinus infection, your doctor may recommend you use a decongestant and saline nasal washes. You shouldn’t use an over-the-counter decongestant more than 3 days, though, because it can make you more congested.

    If your doctor gives you antibiotics, you’ll probably take them for 10 to 14 days. The symptoms usually disappear with treatment.

    Warm, moist air may help if you have chronic sinusitis. You can use a vaporizer, or you can inhale steam from a pan of warm water. Make sure the water isn't too hot. 

    There are some other things you can do yourself to help with chronic sinusitis: 

    • Warm compresses can ease pain in the nose and sinuses.
    • Saline nose drops are safe to use at home.
    • Over-the-counter decongestant drops or sprays can help. Don’t take them longer than recommended.

    In some cases, your doctor may prescribe steroids along with antibiotics.

    Other Options

    You also need to avoid any triggers linked to your sinusitis. Some treatment options include:

    • If you have allergies,your doctor may recommend an antihistamine.
    • If a fungus is to blame, you’ll get a prescription for an antifungal medicine.
    • If you have certain immune deficiencies, your doctor may give you immunoglobulin, which helps fight the things your body reacts to.

    Can I Prevent Sinusitis?

    There is no sure-fire way to prevent sinusitis. But there are some things that might help.

    • Don’t smoke, and try not to be too near people who are smoking.
    • Wash your hands often, especially during cold and flu season, and try not to touch your face.
    • Try to stay away from things you know you’re allergic to.

    Do I Need Sinus Surgery?

    You might, if antibiotics and other medicines don't open the sinus.

    Also, if the structure of your sinuses may not be quite right. For example, nasal polyps may block them and keep them from draining as they should. If that’s the case, your doctor may talk to you about some type of procedure.

    Reviewed by William Blahd, MD on May 05, 2016

    Sources: Sources

    This tool does not provide medical advice. See additional information: Disclaimer

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