Sinusitis: Causes, Symptoms & Treatment

Sinusitis, also called rhinosinusitis, is inflammation of the paranasal sinuses (air-filled cavities around the nose and eyes). The sinuses normally produce mucus that drains through the nose. When inflammation or infection blocks drainage, mucus accumulates, causing pain, congestion, and pressure. Sinusitis can be acute (lasting less than 4 weeks), subacute, or chronic (lasting more than 12 weeks).

Viral infections are the most common cause of acute sinusitis, while allergies and anatomical obstruction are common chronic causes.

Acute causes:

• Viral upper respiratory infection (most common)
• Bacterial infection
• Allergic rhinitis
• Irritant exposure

Chronic causes:

• Recurrent infections
• Allergies
• Anatomical obstruction (deviated septum, polyps)
• Immunosuppression
• Gastroesophageal reflux
• Cystic fibrosis

Symptoms include:

• Nasal congestion
• Facial pain or pressure
• Nasal drainage (clear, yellow, or green)
• Cough (especially at night)
• Headache
• Fever (in acute bacterial infection)
• Hyposmia (reduced smell)
• Post-nasal drip

Diagnosis involves:

• Clinical history and symptoms
• Nasal examination (rhinoscopy)
• CT imaging (for chronic or complicated cases)
• Nasal endoscopy

Acute viral sinusitis:

• Supportive care (fluids, rest)
• Nasal saline irrigation
• Decongestants (phenylephrine)
• Analgesics for pain
• Topical or systemic corticosteroids

Bacterial sinusitis:

• Broad-spectrum antibiotics (amoxicillin-clavulanate)
• Duration: 7-10 days

Chronic sinusitis:

• Nasal corticosteroid sprays
• Nasal saline irrigation
• Antihistamines (if allergic)
• Functional endoscopic sinus surgery (FESS)

Prevention strategies include:

• Hand hygiene
• Avoiding cigarette smoke
• Managing allergies
• Treating GERD
• Maintaining humidified environment
• Using saline irrigation regularly

See a doctor if symptoms persist beyond 10 days, worsen after improvement, or are severe. Frequent recurrent sinusitis warrants specialist evaluation for underlying causes.