Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses are hollow air spaces within the bones surrounding the nose. They produce mucus, which drains into the nose. If your nose is swollen, this can block the sinuses and cause pain.

There are several types of sinusitis, including

• Acute, which lasts up to 4 weeks
• Subacute, which lasts 4 to 12 weeks
• Chronic, which lasts more than 12 weeks and can continue for months or even years
• Recurrent, with several attacks within a year

Acute sinusitis often starts as a cold, which then turns into a bacterial infection. Allergies, nasal problems, and certain diseases can also cause acute and chronic sinusitis.

Symptoms of sinusitis can include fever, weakness, fatigue, cough, and congestion. There may also be mucus drainage in the back of the throat, called postnasal drip. Your health care professional diagnoses sinusitis based on your symptoms and an examination of your nose and face. You may also need imaging tests. Treatments include antibiotics, decongestants, and pain relievers. Using heat pads on the inflamed area, saline nasal sprays, and vaporizers can also help.

Sinusitis is swelling of the tissues lining the sinuses. The sinuses are hollow air filled cavities within the cheekbones, around the eyes and behind the nose. The cells in the lining of the sinuses secrete mucus. The mucus helps to warm, moisten and filter the air you breathe. It traps dust, germs and other particles in the air. Tiny hair-like projections in the sinuses sweep the mucus and whatever is trapped in it towards openings that lead to the back of the throat. From there, it slides down to the stomach. Sinusitis can be caused by infection, allergies, and chemical or particulate irritation of the sinuses. The source of infections may be bacteria, viruses or fungi (molds). The tiny hair-like "sweepers" become blocked when infections or allergies cause tiny nasal tissues to swell. The swelling traps mucus in the sinuses. Bacteria in the mucus grows and the sinuses become infected. Because the sinus cavity is so close to the brain, sinus infections can be life threatening if they are not treated immediately. By stopping a sinus infection early, you avoid later symptoms and complications.

Initial symptoms resemble the common cold: headaches or facial pain, runny nose and nasal congestion. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead.

Who is most likely to develop sinusitis? People, who suffer from allergies, asthma, structural blockages in the nose or sinuses, or weak immune systems, are at greater risk. People with weak immune systems are more likely to develop bacterial or fungal sinusitis.

Types of Sinusitis:

1. Acute sinusitis - lasts from 10 days up to 4 weeks
2. Subacute sinusitis - lasts from 4 weeks to 8 weeks
3. Chronic sinusitis - lasts more than 8 weeks
4. Persistent sinusitis - person develops sinusitis several times throughout the year

Acute sinusitis may be diagnosed when a person has two or more symptoms and/or the presence of thick, green, or yellow nasal discharge. The five most common bacterial sinus infections are with:

• Streptococcus pneumoniae
• Haemophilus influenza
• Moraxella catarrhalis
• Staphylococcus aureus
• Streptococcus pyogenes.

Bacterial infections must be treated with antibiotics. Subacute and chronic forms of sinus infection usually are the result of incomplete treatment of an acute sinus infection.

The paranasal sinuses are hollow, air-filled spaces located within certain bones of the skull (image). All of the sinuses communicate with the nasal cavity (paranasal = “next to nasal cavity”) and are lined with nasal mucosa. They serve to reduce bone mass and thus lighten the skull, and they also add resonance to the voice. This second feature is most obvious when you have a cold or sinus congestion. These produce swelling of the mucosa and excess mucus production, which can obstruct the narrow passageways between the sinuses and the nasal cavity, causing your voice to sound different to yourself and others. This blockage can also allow the sinuses to fill with fluid, with the resulting pressure producing pain and discomfort.

The paranasal sinuses are named for the skull bone that each occupies. The frontal sinus is located just above the eyebrows, within the frontal bone (see image). This irregular space may be divided at the midline into bilateral spaces, or these may be fused into a single sinus space. The frontal sinus is the most anterior of the paranasal sinuses. The largest sinus is the maxillary sinus. These are paired and located within the right and left maxillary bones, where they occupy the area just below the orbits. The maxillary sinuses are most commonly involved during sinus infections. Because their connection to the nasal cavity is located high on their medial wall, they are difficult to drain. The sphenoid sinus is a single, midline sinus. It is located within the body of the sphenoid bone, just anterior and inferior to the sella turcica, thus making it the most posterior of the paranasal sinuses. The lateral aspects of the ethmoid bone contain multiple small spaces separated by very thin bony walls. Each of these spaces is called an ethmoid air cell. These are located on both sides of the ethmoid bone, between the upper nasal cavity and medial orbit, just behind the superior nasal conchae.

The major entrance and exit for the respiratory system is through the nose. When discussing the nose, it is helpful to divide it into two major sections: the external nose, and the nasal cavity or internal nose.

The external nose consists of the surface and skeletal structures that result in the outward appearance of the nose and contribute to its numerous functions. The root is the region of the nose located between the eyebrows. The bridge is the part of the nose that connects the root to the rest of the nose. The dorsum nasi is the length of the nose. The apex is the tip of the nose. On either side of the apex, the nostrils are formed by the alae (singular = ala). An ala is a cartilaginous structure that forms the lateral side of each naris (plural = nares), or nostril opening. The philtrum is the concave surface that connects the apex of the nose to the upper lip.

Underneath the thin skin of the nose are its skeletal features. While the root and bridge of the nose consist of bone, the protruding portion of the nose is composed of cartilage. As a result, when looking at a skull, the nose is missing. The nasal bone is one of a pair of bones that lies under the root and bridge of the nose. The nasal bone articulates superiorly with the frontal bone and laterally with the maxillary bones. Septal cartilage is flexible hyaline cartilage connected to the nasal bone, forming the dorsum nasi. The alar cartilage consists of the apex of the nose; it surrounds the naris.

The nares open into the nasal cavity, which is separated into left and right sections by the nasal septum. The nasal septum is formed anteriorly by a portion of the septal cartilage (the flexible portion you can touch with your fingers) and posteriorly by the perpendicular plate of the ethmoid bone (a cranial bone located just posterior to the nasal bones) and the thin vomer bones (whose name refers to its plough shape). Each lateral wall of the nasal cavity has three bony projections, called the superior, middle, and inferior nasal conchae. The inferior conchae are separate bones, whereas the superior and middle conchae are portions of the ethmoid bone. Conchae serve to increase the surface area of the nasal cavity and to disrupt the flow of air as it enters the nose, causing air to bounce along the epithelium, where it is cleaned and warmed. The conchae and meatuses also conserve water and prevent dehydration of the nasal epithelium by trapping water during exhalation. The floor of the nasal cavity is composed of the palate. The hard palate at the anterior region of the nasal cavity is composed of bone. The soft palate at the posterior portion of the nasal cavity consists of muscle tissue. Air exits the nasal cavities via the internal nares and moves into the pharynx.

Several bones that help form the walls of the nasal cavity have air-containing spaces called the paranasal sinuses, which serve to warm and humidify incoming air. Sinuses are lined with a mucosa. Each paranasal sinus is named for its associated bone: frontal sinus, maxillary sinus, sphenoidal sinus, and ethmoidal sinus. The sinuses produce mucus and lighten the weight of the skull.

The nares and anterior portion of the nasal cavities are lined with mucous membranes, containing sebaceous glands and hair follicles that serve to prevent the passage of large debris, such as dirt, through the nasal cavity. An olfactory epithelium used to detect odors is found deeper in the nasal cavity.

The conchae, meatuses, and paranasal sinuses are lined by respiratory epithelium composed of pseudostratified ciliated columnar epithelium. The epithelium contains goblet cells, one of the specialized, columnar epithelial cells that produce mucus to trap debris. The cilia of the respiratory epithelium help remove the mucus and debris from the nasal cavity with a constant beating motion, sweeping materials towards the throat to be swallowed. Interestingly, cold air slows the movement of the cilia, resulting in accumulation of mucus that may in turn lead to a runny nose during cold weather. This moist epithelium functions to warm and humidify incoming air. Capillaries located just beneath the nasal epithelium warm the air by convection. Serous and mucus-producing cells also secrete the lysozyme enzyme and proteins called defensins, which have antibacterial properties. Immune cells that patrol the connective tissue deep to the respiratory epithelium provide additional protection.

Several factors can increase your risk of getting a sinus infection:

• A previous cold
• Seasonal allergies
• Smoking and exposure to secondhand smoke
• Structural problems within the sinuses (such as growths on the lining of the nose or sinuses, known as nasal polyps)
• A weak immune system or taking drugs that weaken the immune system

Stuffy nose that just isn’t getting better? You might have a sinus infection, also called sinusitis.

Sinus infections happen when fluid builds up in the air-filled pockets in the face (sinuses), which allows germs to grow. Viruses cause most sinus infections, but bacteria can cause some sinus infections.

Common symptoms of sinus infections include:

• Runny nose
• Stuffy nose
• Facial pain or pressure
• Headache
• Mucus dripping down the throat (post-nasal drip)
• Sore throat
• Cough
• Bad breath

See a doctor if you have:

• Severe symptoms, such as severe headache or facial pain.
• Symptoms that get worse after initially improving.
• Symptoms lasting more than 10 days without improvement.
• Fever longer than 3-4 days.

You should also seek medical care if you have had multiple sinus infections in the past year.

This list is not all-inclusive. Please see a doctor for any symptom that is severe or concerning.

Talk to a healthcare professional right away if your child is younger than 3 months old and has a fever of 100.4 °F (38 °C) or higher.

Your doctor will determine if you have a sinus infection by asking about symptoms and doing a physical examination.

Antibiotics are not needed for many sinus infections. Most sinus infections usually get better on their own without antibiotics. When antibiotics aren’t needed, they won’t help you, and their side effects could still cause harm. Side effects can range from minor issues, like a rash, to very serious health problems, such as antibiotic-resistant infections and C. diff infection, which causes diarrhea that can lead to severe colon damage and death.

However, in some cases, antibiotics are needed. Talk to your doctor about the best treatment for your illness.

For some sinus infections, your doctor might recommend watchful waiting or delayed antibiotic prescribing.

• Watchful waiting: Your child’s doctor may suggest watching and waiting to see if your child needs antibiotics. This gives the immune system time to fight off the infection. If your child doesn’t feel better after 2–3 days of rest, extra fluids, and pain relievers, the doctor may write a prescription for an antibiotic.
• Delayed prescribing: Your child’s doctor may give an antibiotic prescription but suggest that you wait 2–3 days to see if your child is still sick before filling it.

Below are some ways to help relieve sinus pain and pressure:

• Put a warm compress over the nose and forehead to help relieve sinus pressure.
• Use a decongestant or saline nasal spray.
• Breathe in steam from a bowl of hot water or shower.

Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better. Always use over-the-counter medicines as directed.

Be careful about giving over-the-counter medicines to children. Not all over-the-counter medicines are recommended for children of certain ages.

• Pain relievers:
  • Children younger than 6 months: only give acetaminophen.
  • Children 6 months or older: it is OK to give acetaminophen or ibuprofen.
  • Never give aspirin to children because it can cause Reye’s syndrome, a rare but very serious illness that harms the liver and brain.

• Cough and cold medicines:
  • Children younger than 4 years old: do not use unless a doctor specifically tells you to. Use of over-the-counter cough and cold medicines in young children can result in serious and potentially life-threatening side effects.
  • Children 4 years or older: discuss with your child’s doctor if over-the-counter cough and cold medicines are safe to give to your child for temporary symptom relief.

Be sure to ask your doctor or pharmacist about the right dosage of over-the-counter medicines for your child’s age and size. Also, tell your child’s doctor and pharmacist about all prescription and over-the-counter medicines they are taking.

You can help prevent sinus infections by doing your best to stay healthy and keep others healthy, including:

• Clean your hands.
• Receive recommended vaccines, such as the flu vaccine and pneumococcal vaccine.
• Avoid close contact with people who have colds or other upper respiratory infections.
• Don’t smoke and avoid secondhand smoke.
• Use a clean humidifier to moisten the air at home.

Little teapots with long spouts have become a fixture in many homes to flush out clogged nasal passages and help people breathe easier.

Along with other nasal irrigation devices, these devices — commonly called neti pots — use a saline, or saltwater, solution to treat congested sinuses, colds and allergies. They’re also used to moisten nasal passages exposed to dry indoor air. But be careful. Improper use of these neti pots and other nasal irrigation devices can increase your risk of infection.

Nasal irrigation devices — which include neti pots, bulb syringes, squeeze bottles, and battery-operated pulsed water devices — are usually safe and effective products when used and cleaned properly, says Eric A. Mann, M.D., Ph.D., a doctor at the FDA.

Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated. Some tap water contains low levels of organisms — such as bacteria and protozoa, including amoebas — that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections. They can even be fatal in some rare cases, according to the Centers for Disease Control and Prevention (CDC).