What you need to know about acute sinusitis

Acute sinusitis is when the cavities around your nasal passages become inflamed and swollen. This leads to mucus buildup and interferes with drainage. This makes it difficult to breathe through your nose.

The area around your eyes and face might feel swollen and you might have throbbing facial pain or a headache. Acute sinusitis is mostly caused by the common cold.

However, persistent sinusitis can lead to serious infections and other complications. Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis.

Contact your doctor if you have any of the following:

• Symptoms that worsen.
• A persistent fever.
• A history of recurrent or chronic sinusitis.

Symptoms

Acute sinusitis symptoms often include:

• Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat.
• Nasal obstruction or congestion, causing difficulty breathing through your nose.
• Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead that worsens when bending over.

Risk factors

You may be at increased risk of getting sinusitis if you have:

• Hay fever or another allergic condition that affects your sinuses.
• A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumours.
• A medical condition such as cystic fibrosis or an immune system disorder such as HIV/Aids.

Picture: iStock

Complications

Acute sinusitis complications are uncommon. If they occur, they might include:

• Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.

• Meningitis. This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.

• Other infections. Uncommonly, infection can spread to the bones (osteomyelitis) or skin (cellulitis).

• Partial or complete loss of sense of smell. Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause loss of smell.

• Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.

Diagnosis

Consult your doctor who will do a history and physical examination which includes feeling for tenderness in your nose and face and looking inside your nose.

Other methods that might be used to diagnose acute sinusitis and rule out other conditions include:

• Nasal endoscopy. A thin, flexible tube (endoscope) with a fibre-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.

• Imaging studies. A CT scan or MRI can show details of your sinuses and nasal area. While not recommended for uncomplicated acute sinusitis, imaging studies might help identify abnormalities or suspected complications.

• Nasal and sinus cultures. Laboratory tests are generally unnecessary for diagnosing acute sinusitis. However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.

• Allergy testing. If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that’s responsible for your nasal flare-ups.

Picture: iStock

Treatment

Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Self-care techniques are usually all you need to ease symptoms.

Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

• Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.

• Nasal corticosteroids. These nasal sprays help prevent and treat inflammation.

• Decongestants. These medications are available in over-the-counter and prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few days. Otherwise they may cause the return of more severe congestion (rebound congestion).

• Over the counter pain relievers, such as paracetamol, acetaminophen or ibuprofen. Use caution when giving aspirin to children or teenagers.

• Antibiotics usually aren’t needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment.

• Immunotherapy. If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body’s reaction to specific allergens may help treat your symptoms.

• Alternative medicine. No alternative therapies have been proved to ease the symptoms of acute sinusitis, but products containing certain combinations of herbs may help.

Picture: iStock

Lifestyle and home remedies

• Rest. This will help your body fight infection and speed recovery.

• Drink water. This will help dilute mucous secretions and promote drainage.

• Keep your sinus cavities moist. Drape a towel over your head as you breathe in the vapour from a bowl of hot water. Keep the vapour directed toward your face.

• Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain.

• Rinse your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others). This home remedy, called nasal lavage, can help clear your sinuses. Use water that is clean-distilled, sterile, previously boiled and cooled – to make up the irrigation solution.

• Sleep with your head elevated. This will help your sinuses drain, reducing congestion.

Prevention

Take these steps to reduce risk:

• Avoid upper respiratory infections. Minimise contact with people who have colds. Wash your hands frequently with soap and water.

• Avoid cigarette smoke and polluted air. Tobacco smoke can irritate and inflame your lungs and nasal passages.

• Use a humidifier. If the air in your home is dry, adding moisture to the air may help prevent sinusitis.

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