Posted On Dec 23, 2019

Department of

Manipal Hospitals

Sinusitis is an inflammation of the tissues lining the air cavities in the passages of the nose. The sinuses, which are a connected system of hollow cavities in the skull, become blocked and filled with fluid, which results in the growth of germs causing an infection. It is often referred to as rhinosinusitis since the inflammation of the sinuses almost always occurs with inflammation of the nose known as rhinitis. A sinus infection


Conditions that cause sinus blockage are:

  • Respiratory tract infections, such as the common cold, allergic rhinitis, etc.

  • Small growths in the lining of the nose called nasal polyps.

  • Structural problems in the nose such as a deviated septum

  • Weakened immunity due to other health conditions or treatments


Sinusitis is classified based on its duration (acute, subacute, or chronic) and type of inflammation (infectious or non-infectious). It should be noted that there is no medical consensus regarding the duration of this infection.

  • Acute sinus infection: It usually begins suddenly with symptoms like a runny and stuffy nose and facial pain. It lasts for about 2-4 weeks.

  • Subacute sinus infection: It lasts 4-12 weeks.

  • Chronic sinus infection: It lasts longer than three months and may be further classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.

  • Infectious Sinusitis: It is usually caused due to a viral infection, although in few cases it might be caused due to bacterial growth or fungal sinus infection.

  • Non-infectious Sinusitis: It is caused due to irritants and allergic conditions.


The common signs and symptoms of sinusitis are:

  • Sinus headache in which the pain is centered in the face and radiates to the forehead, temple, or cheek.

  • Nasal congestion with the discharge of mucus

  • Postnasal drip, where the mucus drips down the throat behind the nose, often accompanied by sore throat.

  • Fever

  • Persistent cough

  • Ear pain

  • Pain or pressure symptoms which aggravate when coughing or straining

  • Facial swelling

  • Dizziness

  • Chronic toothache, increased tooth sensitivity, and bad breath


Most sinus infections are treated by a general physician or an internal medicine physician. In chronic or severe cases, the patient might be referred to an otolaryngologist, also known as an Ear, Nose, and Throat (ENT) specialist. If the sinusitis is caused due to allergies, the patient is referred to an allergist. In some complex sinus infections, a surgeon who specializes in sinus surgery may be consulted. If the patient experiences an emergency situation, an emergency medicine specialist is consulted.

Most acute cases subside without any treatment. However, some home remedies and over-the-counter (OTC) medications can be taken to provide relief. This help reduce the pain and help unblock the sinuses to allow proper drainage. Simple home remedies include:

  • Drinking plenty of water and beverages such as hot tea to keep oneself hydrated can promote discharge.

  • Steam inhalation, taking a hot shower, and using mentholated preparations can help clear the sinuses.

  • Nasal Irrigation: This procedure involves rinsing and clearing the nasal passages using salt water solution.

  • Warm Compress: Applying a warm compress to the affected areas of the face can relieve some swelling and discomfort.

Other options for treating sinus infections are:

  • For acute cases, synthetic penicillins such as amoxicillin is commonly used. Its side effects include allergic reactions such as swelling of the throat, hives and stomach upset.

  • OTC Nasal Sprays: Oxymetazoline (Afrin), phenylephrine (Neo-Synephrine) and Naphazoline (Naphcon) are very effective in the initial uses, but their effectiveness gradually decreases over repeated usage. Also, some people may become excessively dependent on nasal sprays, resulting in a disorder called rhinitis medicamentosum. One can overcome this dependency by following a withdrawal program consisting of oral decongestants, saline, steroid nasal sprays individually or in any combination.

  • OTC Steroid Nasal Sprays: Budesonide (Rhinocort), fluticasone (Flonase), and triamcinolone (Nasacort) are some steroids that can reduce inflammation of the nasal passageways.

  • OTC Oral Decongestants: These are taken in the form of tablets or liquid and contain pseudoephedrine or phenylephrine. They work slower than nasal sprays, and like sprays, lose their effectiveness with repeated use.
  • Pain medication such as ibuprofen and naproxen can also reduce the pain and inflammation and help open up the nasal passages.

As in most medical conditions, prevention is the best option for complications. Simple measures like practicing good hand hygiene, avoiding smoking, keeping oneself vaccinated, staying away from people with colds and other respiratory infections, etc. can go a long way in keeping one safe and healthy.

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