Acute Sinusitis

What is acute sinusitis?

Acute sinusitis is one of the two main types of sinusitis. (The other is chronic sinusitis). People with acute sinusitis experience symptoms for less than three months, then their symptoms resolve. Nearly all episodes of acute sinusitis are initially viral upper respiratory infections, also known as the “common cold.” Recurrent acute sinusitis refers to acute sinusitis occurring multiple times a year as separate episodes, between which patients’ sinusitis symptoms resolve.

Our experts treat acute sinusitis on a case-by-case basis, as no two diagnoses are exactly the same. We offer numerous treatment options to help you overcome your symptoms and get back to living your normal life.

Acute sinusitis symptoms

The symptoms of acute and recurrent acute sinusitis are very similar to chronic sinusitis, with the main difference being the duration of symptoms. Symptoms include:

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

Acute sinusitis treatment options

Depending on the severity of your condition and the cause of your symptoms, there are treatment options available to help ease or even eliminate your symptoms entirely. Treatment options include:

  • Antibiotics: When symptoms of sinusitis have continued or worsened over 7-10 days, it is more likely that a viral sinusitis has turned into a bacterial sinusitis, and therefore antibiotics may be warranted. Typically, antibiotics are given for 7-14 days after which the patient’s symptoms are reassessed.
  • Decongestants: Medications like oral pseudoephedrine and nasal oxymetazoline sprays help alleviate nasal obstruction by constricting blood vessels in the sinus and nasal tissues, shrinking the swollen tissues. Nasal decongestants should only be used for at most 2-3 days in a row, to avoid dependency.
  • High-volume saline irrigations (240 mL squeeze bottle preferred): Saline solutions are usually prescribed for use 2-3 times per day until symptoms subside.
  • Expectorants: Medications such as Mucinex (Guaifenesin) can help thin the mucus, making it easier to blow out the nose or cough up, though evidence on the success of this treatment is limited, and should be considered on a case-by-case basis.
  • Nasal steroid sprays: Several brands of nasal steroid sprays exist either as prescription or over-the-counter medications, all with similar effectiveness in reducing inflammation in the nose. Evidence supporting their use for acute sinusitis is limited as well, and can be considered on a case-by-case basis.
  • Antihistamines: These should only be given during episodes of acute sinusitis if a patient is also experiencing significant symptoms of allergic rhinitis (sneezing, itchy eyes and nose, watery eyes, wheezing).
  • Endoscopic sinus surgery: While surgery is more common for patients with chronic sinusitis, if patients with recurrent acute sinusitis experience four or more episodes of sinusitis per year, research shows that sinus surgery can decrease the number of infections every year, and lessen the severity and duration of symptoms if patients do experience infections.

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