Acute sinusitis (a short-lived bout with sinusitis) typically lasts for less than four weeks; chronic sinusitis can last much longer.
Acute sinusitis often starts as a viral respiratory infection, or cold. This will interfere with the normal defense mechanisms in the nose. The normal flow of mucus from the sinuses to the nose and then to the throat can become impaired, often resulting in the development of a bacterial infection. Allergies, pollutants, nasal foreign bodies, fungal contamination, and immune defects can also cause sinusitis.
Symptoms of sinusitis can include fever, weakness, fatigue, cough, and congestion. There may also be post-nasal drip (mucus drainage) in the back of the throat.
The symptoms of chronic sinusitis are similar to acute sinusitis, except they last longer and often cause more significant fatigue. Chronic sinusitis symptoms can include:
- Drainage from the nose or down the back of the throat
- Nasal obstruction or congestion
- Pain, tenderness and swelling around the eyes, cheeks, nose, or forehead
- Reduced sense of smell and taste
- Cough, which may be worse at night
- Ear pain
- Aching in the upper jaw and teeth
- Sore throat
- Bad breath (halitosis)
In most cases, symptoms of an acute viral sinusitis can be treated symptomatically at home. Persistent symptoms beyond a week or two, a fever, or the development of facial or eye swelling should prompt a doctor’s evaluation.
Common treatments include decongestants and pain relievers. Heat, saline nasal sprays, and vaporizers can all aid in relieving symptoms. Antibiotics are often not needed when treating acute rhinosinusitis since antibiotics won’t help when acute sinusitis is caused by a viral infection.
Chronic sinusitis often requires medical attention. The goal in treating chronic sinusitis symptoms is to reduce sinus inflammation, improve nasal breathing, address the underlying cause, and significantly reduce the number of episodes. CT scanning is often helpful along with nasal endoscopy, an office procedure used to visualize the internal structures of the nose.
Typical treatment options can include:
- Saline spray to rinse nasal passages
- Nasal corticosteroids (nasal sprays) to prevent inflammation
- Injected or oral corticosteroids to relieve inflammation from severe sinusitis, especially that caused by nasal polyps
- Nasal decongestants, which should only be taken for a few days
- Over-the-counter pain relievers such as aspirin, acetaminophen or ibuprofen
- Antifungal medication may be necessary if the sinusitis is caused by a fungal infection
- Antibiotics to treat sinusitis caused by bacteria
- Allergy shots (immunotherapy)
- Endoscopic sinus surgery. This is an option in cases that do not respond to medical treatment. In this procedure, the otolaryngologist utilizes a CT scan of the sinuses to identify structural problems of the sinuses that are preventing normal drainage. Working through the nostrils, an endoscope is used to resect the obstructed areas and re-establish proper flow. A neuro navigational imaging system, basically a GPS for the nose, is utilized during the surgery to visualize the limits of the sinuses and prevent damage to the eye socket or skull base. Patients usually are able to go home on the same day as their surgery.