What is sinusitis and what can I do about it?

What is sinusitis and what can I do about it?

We know you have questions. Dr. Farhad Sigari and the staff of Del Rey Sinus Institute are expert in the treatment of sinus conditions, and we can help. Over the years we have encountered countless cases of sinusitis, including ones just like yours.

What is sinusitis?

Like all medical terms ending in “itis,” sinusitis is an inflammation or swelling of tissues, in this case in the sinus cavity. There are two kinds, acute (or acute bacterial) and chronic, which are similar in some but not all aspects:

  • Acute sinusitis is a sudden onset of cold symptoms such as a runny nose, congestion or facial pain.
  • Chronic sinusitis is an ongoing condition that may include nasal congestion, post-nasal drip and facial pain. Symptoms last for 12 weeks or more.

What are the symptoms of sinusitis?

Symptoms include:

  • Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (post-nasal drip)
  • Nasal obstruction or congestion, causing difficulty breathing through your nose
  • Pain, pressure or swelling around your eyes, cheeks, nose or forehead

Other signs and symptoms can include:

  • Headaches
  • Sinus pain or pressure
  • Jaw or tooth pain
  • Reduced sense of smell and taste
  • Cough
  • Bad breath (halitosis)
  • Fatigue
  • Fever

In addition to inflammation, chronic sinusitis may include one or more of the following symptoms:

  • Thick, discolored discharge from the nose or drainage down the back of the throat (post-nasal drip)
  • Nasal obstruction or congestion, causing difficulty breathing through your nose
  • Pain and swelling around your eyes, cheeks, nose or forehead
  • Reduced sense of smell and taste in adults or cough in children

Other signs and symptoms can include:

  • Ear pain
  • Sore throat
  • Cough, especially at night
  • Bad breath (halitosis)
  • Fatigue
  • Nausea

As you can see, chronic and acute sinusitis may be similar and have some of the same symptoms, but acute sinusitis is a temporary infection of the sinuses, mostly from the common cold. The symptoms of chronic sinusitis last longer, and because sleep may be disturbed, fatigue is a bigger factor. Fever isn’t a common sign of chronic sinusitis, but you might have one with acute sinusitis.

How do you diagnose sinusitis?

The exam is basically the same, whether it’s acute or chronic. The doctor will feel for tenderness in your nose and face and look inside your nose.

Other methods that might be used include:

  • Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
  • Imaging studies. We have an in-house CT scanner that can show details of your sinuses. This can help us identify abnormalities or suspected complications, particularly for chronic sinusitis.
  • 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 allergies may have triggered your acute sinusitis, we may recommend an allergy skin test. A skin test is safe and quick, and can help pinpoint the allergen that’s responsible for your nasal symptoms.

What are the treatment options?

For acute sinusitis, believe it or not we advise you to self-treat. Most cases will resolve on their own.

You may use one of the following, which we can recommend on examination:

  • Saline nasal spray.
  • Nasal corticosteroids. These nasal sprays help prevent and treat inflammation and include Flonase, Veramyst, budesonide (Rhinocort), mometasone (Nasonex) and others.
  • Decongestants, either over the counter or prescription. These are to be used for a limited time.
  • Over-the-counter pain relievers, such as aspirin, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin IB, others).
  • Antibiotics usually aren’t needed to treat acute sinusitis, unless symptoms get progressively worse. If we prescribe antibiotics, you must take the entire course or your symptoms could recur.
  • Immunotherapy drops. If allergies are contributing to your sinusitis, allergy drops that help reduce the body’s reaction to specific allergens may help treat your symptoms.

For chronic sinusitis, the treatments are designed to reduce inflammation, drain sinuses, and control the causes and number of occurrences. Treatments are similar to those for acute sinusitis, including:

  • Saline nasal spray.
  • Nasal corticosteroids.
  • Oral or injected corticosteroids. These are stronger medications that can relieve inflammation, especially in cases of nasal polyps.
  • Antibiotics. These can be needed if you have a bacterial infection. We may recommend antibiotics, sometimes in combination with other medications.
  • Immunotherapy drops.
  • Endoscopic sinus surgery. When you feel you have tried everything, and treatment and medications are just not working, you may opt for sinus surgery. We use a thin, flexible tube with an attached light (endoscope) to explore your sinus passages. We may also remove tissue or shave away obstructions causing nasal blockage.
  • Minimally invasive sinus surgery. We are specialists in balloon sinus dilation, where a balloon will open your sinus passages. In one simple treatment, many people gain a lifetime of relief.

Take care of your sinuses and breathe better today! See our Facebook page and Twitter feeds for more tips on keeping sinuses healthy and happy. If you need us, just call at (310) 823-4444

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