Sinus illustration superimposed on woman's face
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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.

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Frontal CAT scan showing normal sinuses
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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.

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cilia lining the sinus cavity's mucus membrane
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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.

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Nostril breathing in rhinovirus and pollen spore
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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.

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Woman touching face
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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.

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MRI showing stuffed up sinuses
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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.

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Anterior rhinoscopy showing nasal polyposis
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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.

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Man using nasal spray
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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.

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Rhinovirus 14, responsible for the common cold
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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.

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Woman using nasal rinse
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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.

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Girl with runny nose
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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.

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surgeon using endoscope to remove sinus mucosa
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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.

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X-ray of a patient with acute sinusitis
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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.

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man tilting head towards sun, breathing
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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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Sources | Medically Reviewed on 05/05/2016 Reviewed by William Blahd, MD on May 05, 2016

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REFERENCES: 

American College of Physicians, PIER: Physicians Information and Education Resource web site.
Jim Young, PhD, biostatistician, Basel Institute for Clinical Epidemiology, University Hospital Basel, Switzerland.
Joe, S.A. Otolaryngology -- Head & Neck Surgery, September 2008.
Jordan S. Josephson, MD, director, New York Nasal and Sinus Center and author, Sinus Relief Now, Perigee Trade, December 2006.
Harvey, R. Cochrane Database Systematic Reviews, Jul. 18, 2007.
Ian G. Williamson, MD, senior lecturer, University of Southampton, England.
Lim, M. American Journal of Rhinology, July/August 2008.
Lindbaek, M. Journal of the American Medical Association, Dec. 5, 2007.
Morten Lindbaek, MD, PhD, professor, University of Oslo, Norway.
National Institute of Allergy and Infectious Diseases web site.
Piccirillo, J.F. The New England Journal of Medicine, Aug. 26, 2004.
Schumann, S.A. and Hickner, J. Journal of Family Practice, July 2008.
Williamson, I.G. Journal of the American Medical Association, Dec. 5, 2007.

Reviewed by William Blahd, MD on May 05, 2016

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

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.