Sinusitis

written by Harvard Medical School

www.patientedu.org

Sinusitis

HMS Broch-Sinusitis-3.FINAL:Layout 1 1/20/12 9:18 AM Page 1

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About 20 million Americanswill have at least one bout ofsinusitis this year. Nearly allwill recover, but an unfortu-nate few may develop seriouscompli cations. If you under-stand sinusitis, you’ll knowhow to speed your recovery and lower the risk of complications.

2

For more information about sinusitis from Harvard Health Publications, go to www.patientedu.org.

Your SinusesYour sinuses are four pairs of air-filled chamberslocated in the bones of your face. The frontalsinuses are behind the forehead; the maxillarysinuses are behind the cheeks; the ethmoid sinusesare behind the bridge of the nose; and the sphe-noid sinuses are deeper in the skull behind thenose (see images below).

A membrane that produces mucus lines the sinuses. When you’re healthy, the mucus is a thin, watery fluid that flows freely into the upperpart of your nose. But when your sinuses becomeinflamed, the mucus gets thick and sticky, so itcan’t flow through the tiny openings that lead tothe nose. Fluid builds up in the sinuses, causingpressure and pain—it’s sinusitis.

What Causes Sinusitis?Sinusitis is an infection caused by bacteria. All of us harbor millions of bacteria in our noses, and many of us have one or more of the germsthat cause sinusitis. These bacteria are harmless inthe nose, and they don’t even cause trouble when

frontalsinuses

ethmoidsinuses

sphenoidsinuses

maxillarysinuses


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About 20 million Americanswill have at least one bout ofsinusitis this year. Nearly allwill recover, but an unfortu-nate few may develop seriouscompli cations. If you under-stand sinusitis, you’ll knowhow to speed your recovery and lower the risk of complications.

2

For more information about sinusitis from Harvard Health Publications, go to www.patientedu.org.

Your SinusesYour sinuses are four pairs of air-filled chamberslocated in the bones of your face. The frontalsinuses are behind the forehead; the maxillarysinuses are behind the cheeks; the ethmoid sinusesare behind the bridge of the nose; and the sphe-noid sinuses are deeper in the skull behind thenose (see images below).

A membrane that produces mucus lines the sinuses. When you’re healthy, the mucus is a thin, watery fluid that flows freely into the upperpart of your nose. But when your sinuses becomeinflamed, the mucus gets thick and sticky, so itcan’t flow through the tiny openings that lead tothe nose. Fluid builds up in the sinuses, causingpressure and pain—it’s sinusitis.

What Causes Sinusitis?Sinusitis is an infection caused by bacteria. All of us harbor millions of bacteria in our noses, and many of us have one or more of the germsthat cause sinusitis. These bacteria are harmless inthe nose, and they don’t even cause trouble when

frontalsinuses

ethmoidsinuses

sphenoidsinuses

maxillarysinuses


54

a few creep up into the sinuses—as long as theydrain back into the nose. But if sinus drainage isblocked, the bacteria multiply and cause infection.Blockage is the main reason we get sinusitis—andgood drainage is the key to treatment.

What Triggers Sinusitis?The common cold is the leading culprit. Viruses,not bacteria, cause colds, and antibiotics are use-less for treatment. But viruses produce swelling of the nasal tissues, which can block the sinuses.Colds also change the mucus, preventing it fromdoing its normal job of trapping bacteria.

You may get some sinus pressure when you get acold, but that doesn’t mean you have sinusitis orthat you need an antibiotic. Only about one coldin 100 leads to sinusitis, and you can make theodds work for you by doing what it takes to keepyour sinuses draining (see page 6). And rememberto blow your nose gently without pinching it tight-ly, so you won’t force bacteria up into your sinuses.

Many other things can block your sinuses andlead to infection. The list includes allergies, ciga-rette smoke and other irritating fumes, changes inbarometric pressure during flying or scuba diving,nasal polyps, and a deviated nasal septum.

SymptomsPainful pressure is the main symptom. Dependingon which sinus is involved (see page 3), the pain isin the forehead, over the cheek or in the upper jawand teeth, behind the eyes, or at the top of thehead. Sinus pain increases when you bend forward.

Nasal congestion and a thick, dark-colored nasaldischarge are also common. When the mucusdrips into your throat from the back of your nose, you’ll notice a foul taste and you may getbad breath or a cough. You may temporarily loseyour sense of smell or taste. Finally, you may feelfeverish, achy, and tired.

DiagnosisIn most cases, your doctor can diagnose sinusitisfrom your symptoms. If pressing over your sinusescauses pain, sinusitis is likely. If complications aresuspected, or if your sinusitis is unusually severe, a CT scan is very helpful.


54

a few creep up into the sinuses—as long as theydrain back into the nose. But if sinus drainage isblocked, the bacteria multiply and cause infection.Blockage is the main reason we get sinusitis—andgood drainage is the key to treatment.

What Triggers Sinusitis?The common cold is the leading culprit. Viruses,not bacteria, cause colds, and antibiotics are use-less for treatment. But viruses produce swelling of the nasal tissues, which can block the sinuses.Colds also change the mucus, preventing it fromdoing its normal job of trapping bacteria.

You may get some sinus pressure when you get acold, but that doesn’t mean you have sinusitis orthat you need an antibiotic. Only about one coldin 100 leads to sinusitis, and you can make theodds work for you by doing what it takes to keepyour sinuses draining (see page 6). And rememberto blow your nose gently without pinching it tight-ly, so you won’t force bacteria up into your sinuses.

Many other things can block your sinuses andlead to infection. The list includes allergies, ciga-rette smoke and other irritating fumes, changes inbarometric pressure during flying or scuba diving,nasal polyps, and a deviated nasal septum.

SymptomsPainful pressure is the main symptom. Dependingon which sinus is involved (see page 3), the pain isin the forehead, over the cheek or in the upper jawand teeth, behind the eyes, or at the top of thehead. Sinus pain increases when you bend forward.

Nasal congestion and a thick, dark-colored nasaldischarge are also common. When the mucusdrips into your throat from the back of your nose, you’ll notice a foul taste and you may getbad breath or a cough. You may temporarily loseyour sense of smell or taste. Finally, you may feelfeverish, achy, and tired.

DiagnosisIn most cases, your doctor can diagnose sinusitisfrom your symptoms. If pressing over your sinusescauses pain, sinusitis is likely. If complications aresuspected, or if your sinusitis is unusually severe, a CT scan is very helpful.


76

Treatment: Promoting DrainagePeople with early sinusitis can recover simply bypromoting drainage. Here’s what to do:

• Drink lots of water. Good hydrationhelps keep the mucus thin and loose.

• Sleep with your head elevated. If yourpain is only on one side, sleep with thepain-free side of your face on the pillow.

• Inhale steam. Linger in a hot shower.Boil a kettle, pour the water into apan, and bend over the pan with atowel over your head to inhale thesteam. Even hot tea or chicken soupwill help; the secret ingredient is thesteam. One way or another, inhalesteam three to four times a day.

• Ask your doctor about prescription nasalsprays containing steroids, particularly if youhave allergies or if your sinusitis is stubborn.

• Use a salt-water nasal spray to loosen mucusand rinse your sinuses.

• Use decongestants. Tablets con-taining pseudo ephedrine are veryhelpful, but may raise your bloodpressure, speed your pulse, or makeyou jittery and keep you up atnight. Nasal sprays containingoxymetazoline or phenylephrinedon’t have these side effects, but if you use them too often or toolong, your nose can become irri -tated or dependent on them.

• Avoid antihistamines. They’re great for allergiesand when your nose waters from a cold, but theymake mucus thick and hard to drain, the lastthing you want in sinusitis.

• A warm compress on your face may soothe sinuspain. Over-the-counter pain relievers such as aspirinor acetaminophen will help reduce pain and fever.

Treatment: AntibioticsIf your sinusitis does not improve after two tofour days of drainage therapy—or if it’s verysevere to begin with—your doctor will prescribean antibiotic. Many drugs are effective, so yourphysician will decide what’s best for you.

ComplicationsChronic sinusitis causes persistent nasal conges-tion and discharge; headache is less common, andfever is rare. Steroids or surgery may be needed.

Rarely, acute sinusitis can lead to infections of theeye, skull, or brain. Notify your doctor promptlyif you develop a high fever, severe head pain, ared, painful eye, or impaired vision.

Living With Your SinusitisAcute sinusitis is common anduncomfortable. But if youknow how to keep yoursinuses open anddraining freely, youcan keep yoursinuses healthyand happy.


76

Treatment: Promoting DrainagePeople with early sinusitis can recover simply bypromoting drainage. Here’s what to do:

• Drink lots of water. Good hydrationhelps keep the mucus thin and loose.

• Sleep with your head elevated. If yourpain is only on one side, sleep with thepain-free side of your face on the pillow.

• Inhale steam. Linger in a hot shower.Boil a kettle, pour the water into apan, and bend over the pan with atowel over your head to inhale thesteam. Even hot tea or chicken soupwill help; the secret ingredient is thesteam. One way or another, inhalesteam three to four times a day.

• Ask your doctor about prescription nasalsprays containing steroids, particularly if youhave allergies or if your sinusitis is stubborn.

• Use a salt-water nasal spray to loosen mucusand rinse your sinuses.

• Use decongestants. Tablets con-taining pseudo ephedrine are veryhelpful, but may raise your bloodpressure, speed your pulse, or makeyou jittery and keep you up atnight. Nasal sprays containingoxymetazoline or phenylephrinedon’t have these side effects, but if you use them too often or toolong, your nose can become irri -tated or dependent on them.

• Avoid antihistamines. They’re great for allergiesand when your nose waters from a cold, but theymake mucus thick and hard to drain, the lastthing you want in sinusitis.

• A warm compress on your face may soothe sinuspain. Over-the-counter pain relievers such as aspirinor acetaminophen will help reduce pain and fever.

Treatment: AntibioticsIf your sinusitis does not improve after two tofour days of drainage therapy—or if it’s verysevere to begin with—your doctor will prescribean antibiotic. Many drugs are effective, so yourphysician will decide what’s best for you.

ComplicationsChronic sinusitis causes persistent nasal conges-tion and discharge; headache is less common, andfever is rare. Steroids or surgery may be needed.

Rarely, acute sinusitis can lead to infections of theeye, skull, or brain. Notify your doctor promptlyif you develop a high fever, severe head pain, ared, painful eye, or impaired vision.

Living With Your SinusitisAcute sinusitis is common anduncomfortable. But if youknow how to keep yoursinuses open anddraining freely, youcan keep yoursinuses healthyand happy.


PEC-PC-SIN-003

To learn more about sinusitis, visit the PatientEducation Center atwww.patientedu.org/sinusitis.

Printed on 10%post-consumerrecycled paper.

About This Brochure: This brochure was written by practicing physicians from Harvard Medical School. It is part of a series developed and distributed by the Patient Education Center.

All the information in this brochure and on the associated Web site(www.patientedu.org) is intended for educational use only; it is not intended to provide, or be a substitute for, professional medical advice, diagnosis, or treatment. Only a physician or other qualified health care professional can provide medical advice, diagnosis, or treatment. Always consult your physician on all matters of your personal health.

Harvard Medical School, the Patient Education Center, and its affiliates do not endorse any products.

Consulting Physician: Anthony L. Komaroff, MDEditorial Director: Keith D’Oria

Creative Director: Jon Nichol

© Copyright Harvard Medical School.

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HARVAR DMEDICAL SCHOOL

Patient Education Center2127 2nd Ave North

Fort Dodge, IA 50501

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Sinusitis