Rhinosinusitis (patient information)
Rhinoinusitis On the Web
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What are the symptoms of Sinusitis?
- Bad breath or loss of smell
- Cough, often worse at night
- Fatigue and generally not feeling well
- Headache -- pressure-like pain, pain behind the eyes, toothache, or facial tenderness
- Nasal congestion and discharge
- Sore throat and postnasal drip
Symptoms of Rhinosinusitis in children include:
- Cold or respiratory illness that has been improving and then begins to get worse
- High fever, along with a darkened nasal discharge, for at least 3 days
- Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving
What causes Rhinosinusitis?
The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
Rhinosinusitis can occur from one of these conditions:
- Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions.
- Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
- A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.
Rhinosinusitis can be:
Who is at highest risk?
The following may increase your risk or your child's risk of developing Rhinoinusitis:
- Allergic rhinitis or hay fever
- Cystic fibrosis
- Day care
- Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.
- Changes in altitude (flying or scuba diving)
- Large adenoids
- Tooth infections (rare)
- Weakened immune system from HIV or chemotherapy
When to seek urgent medical care?
Call your doctor if:
- Your symptoms last longer than 10 - 14 days or you have a cold that gets worse after 7 days
- You have a severe headache, unrelieved by over-the-counter pain medicine
- You have a fever
- You still have symptoms after taking all of your antibiotics properly
The doctor will examine you or your child for Rhinosinusitis by:
- Looking in the nose for signs of polyps
- Shining a light against the sinus (transillumination) for signs of inflammation
- Tapping over a sinus area to find infection
Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose Rhinosinusitis. This is usually done by doctor who specializes in ear, nose, and throat problems (ENT).
However, these tests are not very sensitive at detecting Rhinosinusitis, and are often considered unnecessary.
- Allergy testing
- Blood tests for HIV or other tests for poor immune function
- Ciliary function tests
- Nasal cytology
- Sweat chloride tests for cystic fibrosis
- Apply a warm, moist washcloth to your face several times a day.
- Drink plenty of fluids to thin the mucus.
- Inhale steam 2 - 4 times per day (for example, sitting in the bathroom with the shower running).
- Spray with nasal saline several times per day.
- Use a humidifier.
- Avoid flying when you are congested.
- Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
- Try acetaminophen or ibuprofen.
Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:
- Children with nasal discharge, possibly with a cough, that is not getting better after 2 - 3 weeks
- Fever higher than 102.2° Fahrenheit (39° Celsius)
- Severe swelling around the eyes
- Headache or pain in the face
Other treatments for Rhinosinusitis include:
- Allergy shots (immunotherapy) to help prevent the disease from returning
- Avoiding allergy triggers
- Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are swollen structures (such as nasal polyps) or allergies
Surgery to clean and drain the sinuses may also be necessary, especially in patients whose inflammation returns, despite medical treatment. An ENT specialist (also known as an otolaryngologist) can perform this surgery.
Where to find medical care for Sinusitis?
What to expect (Outlook/Prognosis)?
Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.
Although very rare, complications may include:
- Bone infection (osteomyelitis)
- Skin infection around the eye (orbital cellulitis)
- Eat plenty of fruits and vegetables, which are rich in antioxidants and other chemicals that could boost your immune systemand help your body resist infection.
- Get an influenza vaccine each year.
- Reduce stress.
- Wash your hands often, particularly after shaking hands with others.
Other tips for preventing rhinosinusitis:
- Avoid smoke and pollutants.
- Drink plenty of fluids to increase moisture in your body.
- Take decongestants during an upper respiratory infection.
- Treat allergies quickly and appropriately.
- Use a humidifier to increase moisture in your nose and sinuses.