Sinusitis is inflammation of the sinuses, which are small air-filled cavities within the bones of the face surrounding the nose. Sinusitis should not be confused with rhinitis, which is characterised by inflammation associated with the mucosal surface of the nasal cavity. However, since most cases of sinusitis also include symptoms of rhinitis, the term rhino sinusitis is often used. Sinusitis can be acute, sub-acute, chronic or recurrent acute; categorisation is dependent upon duration and frequency of symptoms. Acute sinusitis typically causes mild symptoms that resolve on their own, but very rarely may progress into severe or even life-threatening complications, such as a brain abscess. Chronic sinusitis causes persistent symptoms and is often difficult to treat.

Frequently Asked Questions

In contrast to the nasal passages that are heavily colonized with bacteria, the paranasal sinuses are generally free from harmful bacteria or other pathogens. However, the drainage openings (Ostia) that allow the sinuses to empty into the nasal cavity are relatively small and are thus vulnerable to becoming blocked easily. When this drainage system is blocked, the stagnant mucus begins to accumulate, allowing bacteria and other pathogens to colonize in the sinus cavity, resulting in inflammation and infection (i.e., sinusitis). Blockage of the Ostia can occur as a result of direct mechanical obstruction or injury that causes swelling in the nose.

Swelling Factors:

  • Viral upper respiratory tract infection (i.e., common cold)
  • Allergies (e.g., hay fever)
  • Cystic fibrosis Chemical inhalation (e.g., tobacco smoke)
  • Immune disorders Facial injury
  • Changes in atmospheric pressure (e.g., flying, scuba diving)
  • Overusing nasal decongestant sprays

Mechanical & Anatomical Obstructions:

  • Deviated septum
  • Nasal polyps Foreign body
  • Congenital deformity
  • Tumor Nasal bone spur

Distinguishing between sinusitis and other nasal conditions such as allergic rhinitis and the common cold can be difficult since the symptoms are often similar. Viral sinusitis is the most common form of sinus infection and typically produces symptoms similar to those of the common cold that last approximately 10 days. However, symptoms of acute bacterial sinusitis typically last 10-30 days and are more severe than those of the common cold or viral sinusitis. Throbbing facial pain or pressure is a prominent feature in many cases of sinusitis. This symptom typically originates in the same location as the affected sinus (e.g., in the forehead, cheeks, nose, or between the eyes). The pain associated with sinusitis is a result of increased pressure caused by trapped air and mucus, which pushes on the sinus mucous membrane and bony wall behind it.

Sinus pain can also be caused by negative pressure within the sinuses, which occurs due to blocked sinus openings that do not allow air to enter, thus creating a vacuum space.Sinusitis is also often marked by a change in the characteristics of nasal secretions, which progress from clear and watery to thick and opaque (e.g., white, yellowish, greenish, or blood-tinged). The mucus becomes thick because it loses its water content while trapped in the sinus cavity. It also becomes saturated with inflammatory mediators (NIAID 2012) and appears discoloured as it mixes with neutrophils, a type of white blood cell.

Other symptoms linked to sinusitis include:

  • Headache
  • Postnasal drip
  • Sore throat
  • Reduced sense of smell and taste Halitosis (i.e., bad breath)
  • Ear pain/pressure
  • Nasal congestion and runny nose
  • Cough (may be worse at night)
  • Fever
  • Fatigue
  • Aching teeth
  • When symptoms of the common cold or viral sinusitis do not improve after 10 days or worsen after 5 days, bacterial sinusitis may be suspected.
  • Sinusitis can be classified as follows:
  • Acute – Symptoms last less than 4 weeks
  • Sub-acute – Symptoms last from 4 to 8 weeks
  • Chronic – Symptoms last longer than 8 weeks
  • Recurrent acute – Symptoms occur 3 or more times per year and last less than 2 weeks

Adequate rest helps the body fight infection and speed-up recovery. Elevate the head while sleeping by using an extra pillow to reduce congestion and keep the sinuses draining properly. Stay hydrated with water, as this helps to thin out mucus secretions and promote drainage. Sipping hot beverages may also help, since they can dilate blood vessels and promote drainage. Avoid alcohol and caffeine consumption, since they can cause dehydration and contribute to nasal and sinus swelling. Eat a healthy, well-balanced diet, which includes plenty of fruits and vegetables; a diet rich in antioxidants may boost immune function and help fight infection. Try steam inhalation 3-4 times daily to open sinus passages, which can reduce pain and help clear mucus. Breathing in the warm, moist air of a hot shower or use of a humidifier may also be beneficial. Apply a warm, damp towel to painful sinus areas several times a day. Rinse out nasal passages with a saline nasal spray several times a day. This helps to reduce congestion by loosening mucus and cleaning out sinuses and nasal passages. This technique may also have a moisturizing effect, which can reduce the crusting of nasal secretions. Nasal irrigation with a sea salt solution appears to be as effective as saline nasal wash and topical nasal steroids for the management of chronic rhino sinusitis.

Book a consultation with our Health Renewal doctors for Sinusitis.

  • Vitamin C
  • Zinc
  • N-acetyl cysteine
  • Vitamin E
  • Quercetin
  • Viral script
Sharon Izak Elaine Chat staff