What is sinusitis?

Sinusitis refers to inflammation and swelling of the tissue lining, called "mucosa," in the walls of the sinus cavities. For patients with sinusitis, the mucosa becomes inflamed and releases excess mucus that is thicker in texture and may become infected. There are two main categories of sinusitis. These include:

Recurrent acute sinusitis is another classification of acute sinusitis and refers to episodes of sinusitis that last less than three months at a time, but occur multiple times throughout the year. In between episodes, symptoms typically subside.

Sinusitis 101

Sinusitis can be a difficult condition to understand. Is sinusitis an allergy condition? What effect does it have on the sinuses? Can it be cured? Here’s what you need to know about this condition.

Learn More About Sinusitis

CT scan of normal sinuses
Figure A: A computed tomography (CT) scan of normal sinuses. On a CT scan, air in the sinuses appears black, bone appears white, and mucus and swelling appear gray.

CT scan of chronic sinusitis
Figure B: A computed tomography (CT) scan in a patient with chronic sinusitis. The sinuses are either partially or completely filled with gray, meaning there is excess mucus or the tissue lining of the sinuses are swollen.

Sinusitis symptoms

Symptoms include:

  • Nasal obstruction (airflow is blocked in either one or both of the nostrils)
  • Thick and/or foul-smelling or tasting nasal discharge or postnasal drip
  • Facial pain (known as sinus headaches) or pressure across the cheeks or forehead, or over the bridge of the nose between the eyes; less commonly, pain may be at the top of the head or behind the eyes. Pain is more common in acute sinusitis than in chronic sinusitis.
  • Loss of sense of smell (more common in chronic than in acute sinusitis)
  • Fever (more common in acute than in chronic sinusitis)

Not uncommonly, patients experiencing what seems like sinusitis may in fact have allergic rhinitis. While symptoms of allergies may be similar to sinusitis -- nasal obstruction, runny nose, facial pressure, decreased smell and postnasal drip -- symptoms like itchy and/or watery eyes or nose, and sneezing are more likely related to allergies. In addition, allergies tend to intensify during specific times of year, or when exposed to certain environmental triggers, whereas sinusitis symptoms can affect patients at all times of the year. That said, sometimes allergic rhinitis and sinusitis occur together, and patients have all the symptoms of both conditions.

Sinusitis treatment options

Treatment is tailored to the patient’s type of sinusitis and their symptoms. Our team of experienced rhinologists (doctors who specialize in sinus and nasal care) offer both surgical and nonsurgical treatment options, which include:

  • High-volume saline irrigations
  • Nasal steroid sprays
  • Oral antibiotics and steroids
  • Oral decongestants (nasal decongestant can be used for up to 2-3 days at a time, but not longer)
  • Possibly antihistamines or referral to an allergist

If symptoms don’t improve enough with medical therapy, sinus surgery, including endoscopic sinus surgery may be offered to create wider openings to each of the sinuses so that the sinuses can drain more effectively and topical therapies can be delivered more effectively to each of the sinuses. If sinus surgery is required, the overwhelming majority of patients can expect excellent outcomes. A minority of patients may develop recurrent sinus or nasal symptoms after sinus surgery, but their daily quality of life overall should be improved, and the number of courses of medical therapy needed to control their symptoms should be decreased compared to before surgery.

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