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Sinusitis refers to inflammation of the sinuses. This is generally caused by a viral, bacterial, or fungal infection. The sinuses are air-filled spaces around the forehead, cheeks, and eyes that are lined with mucous membranes. Healthy sinuses are sterile (meaning that they contain no bacteria or other organisms) and open, allowing mucus to drain and air to circulate in the nasal passages.
When inflamed, the sinuses become blocked with mucus and can become infected. Each year, over 30 million people (adults and children alike) get sinusitis. Sinusitis can be acute (lasting anywhere from 2 to 8 weeks) or chronic, with symptoms lingering much longer.
The sinuses are openings in the bones around the nose. There are 4 pairs of sinuses connected to the nasal cavity by small openings. Normally, air passes in and out of the sinuses, and mucus and fluid drain from the sinuses into the nose.
Sinusitis occurs when there is infection or inflammation due to allergies in one or more of the sinuses. Acute sinusitis is often associated with upper respiratory infections, as inflammation of the nasal passages prevents drainage of fluid from the sinuses, which allows infection of the sinuses to occur.
The classic symptoms of acute sinusitis usually follow a cold that does not improve, or one that worsens after 5 to 7 days of symptoms. They include:
- Nasal congestion and discharge
- Sore throat and postnasal drip (a sensation of fluid dripping down the back of your throat, particularly at night or when lying down)
- Headache (often described as a pressure-like pain), pain behind the eyes, toothache, or facial tenderness
- Cough, often worse at night
- Fever (may be present)
- Bad breath or loss of smell
- General fatigue and general sense of not feeling well
Chronic sinusitis is much less common than acute sinusitis. When sinusitis recurs frequently, or lasts for a prolonged period of time, it is classified as chronic. While acute sinusitis is usually caused by infection with a single type of bacteria or virus, chronic sinusitis is usually caused either by allergies or by infection with a mixture of different types of bacteria. Chronic sinusitis may have less severe symptoms than acute sinusitis but can cause damage and destruction to the tissues of the sinuses. It may flare up spontaneously or may follow respiratory infections such as colds.
A deviated nasal septum or other obstruction of the nose may also trap fluid in a sinus, causing chronic sinusitis. Dental infections such as tooth abscess may spread into the sinus and infect it directly.
Allergy to the aspergillus species of fungus appears to cause a particularly difficult to treat form of chronic sinusitis.
Symptoms may persist for 3 months or more. Some are:
- Headache (in the front of the head or around the eyes)
- Facial pain around the eyes or in the forehead or cheeks
- Pain in the roof of the mouth or teeth
- Nasal drainage (yellow, yellow-green, thick)