(Sinus Infection; Acute Sinusitis; Chronic Sinusitis)
Sinusitis is inflammation of the sinus cavities. The sinus cavities are air-filled spaces in the skull. It is usually associated with infection.
Sinusitis is called acute if it lasts for less than 4 weeks, subacute if it lasts 4-12 weeks, and chronic if symptoms last for more than 3 months. You may have recurrent sinusitis if you have repeated bouts of acute sinusitis.
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Infectious sinusitis is caused by a bacterial, viral, or (rarely) fungal infection of fluid in the sinus cavities.
Factors that may increase your chance of sinusitis include:
- Recent viral infection
- Smoking or exposure to second-hand smoke
- Other sources of indoor or outdoor air pollution
- Allergies or asthma
- Abnormalities of the facial bones, sinuses, or nasal passages, such as:
- Certain chronic illnesses, including:
- HIV infection and other disorders of the immune system
- Head injury or a medical condition requiring a tube to be inserted into the nose
- Cocaine and other drugs inhaled through the nose
Sinusitis may cause:
- Facial congestion or fullness
- Facial pain or pressure that increases when you bend over or press on the area
- Cough, which is often worse at night
- Nasal congestion not responding well to either decongestants or antihistamines
- Runny nose or postnasal drip
- Thick, yellow, or green mucus
- Bad breath
- Ear pain, pressure, or fullness
- Dental pain
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Sinusitis is diagnosed based on its symptoms and tenderness of the sinuses when pressed.
Tests may include:
- Holding a flashlight up to the sinuses to see if they light up
- CT scan or x-ray of the sinuses to look for fluid in the sinus
- Endoscopic examination of the sinuses—threading a tiny, lighted tube into the nasal cavities to view the sinus opening
- Removing sinus fluid through a needle for testing (rare)
You have may acute sinusitis when the following occurs:
- History of 10 or more days of colored mucous, or visibly infected mucus
- Tenderness over the sinuses
- Difficulty smelling
- Hydrating—Drinking lots of fluids may keep your nasal secretions thin. This will avoid plugging up your nasal passages and sinuses. Saline nasal sprays or irrigation may also loosen nasal secretions.
- Using steam treatments—Keep a humidifier running in your bedroom. Fill a bowl with steaming water every couple of hours. Make a steam tent with a towel over your head. This will let you breathe in the steam.
- Nasal and sinus washes.
- Antibiotics—Used to treat bacterial infections.
Over-the-counter pain relievers.
- Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
- Antihistamines—Help sinusitis symptoms if they are caused by allergies.
- Intranasal corticosteroids—These are inhaled directly into your nose through a nasal spray. Corticosteroids may help relieve congestion by decreasing swelling in the lining of the nose in people with allergies.
- Decongestants—Use either decongestant pills or nasal sprays to shrink nasal passages. Do not use nasal sprays for longer than 3-4 days in a row.
- Guaifenesin—Helps you cough up secretions, but hydration is more effective.
Surgery is a last resort for people with very troublesome, serious chronic sinusitis. It includes:
- Repair of a deviated septum
- Removal of nasal polyps
- Functional endoscopic sinus surgery—a lighted scope is used to enlarge the sinuses to improve drainage
- Balloon sinuplasty—a tube with a balloon attached is inserted into the sinuses (the balloon is inflated to open the sinus passages)
To help reduce your chance of sinusitis:
- Have allergy testing to find out what things you are allergic to and to learn how to treat your allergies.
- Avoid substances you know you are allergic to.
- If you have allergies, stick with your treatment plan.
- If you get a cold, drink lots of fluids and use a decongestant.
- Use sinus washes as directed.
- Blow your nose gently, while pressing one nostril closed.
- If you must travel by air, use a nasal spray decongestant to decrease inflammation prior to takeoff and landing.
- Use a humidifier when you have a cold, allergic symptoms, or sinusitis.
- Use HEPA filters for your furnace and vacuum cleaner to remove allergens from the air.
- Avoid cigarette smoke.
National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov
Calgary Allergy Network http://www.calgaryallergy.ca
Updated August 4, 2014. Accessed September 29, 2014.
Acute sinusitis in children and adolescents. EBSCO DynaMed website. Available at:
Updated February 7, 2014. Accessed September 29, 2014.
Allergic rhinitis, sinusitis, and rhinosinusitis. American Academy of Otolaryngology—Head and Neck Surgery website. Available at:
Accessed September 29, 2014.
Aring AM, Chan MM. Acute rhinosinusitis in adults. Am Fam Physician. 2011;83(9):1057-1063.
Chronic rhinosinusitis. EBSCO DynaMed website. Available at:
Updated April 14, 2014. Accessed September 29, 2014.
Mandell GL, Douglas RG, et al. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA: Churchill Livingstone, Inc; 2000.
Okuyemi KS, Tsue TT. Radiologic imaging in the management of sinusitis. Am Fam Physician. 2002;66(10):1882-1886.
Rakel RE, Bope ET. Conn’s Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Sinusitis (sinus infection). National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH) website. Available at:
Accessed September 29, 2014.
Stewart AE, Vaughan WC. Balloon sinuplasty versus surgical management of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010;10(3):181-187.
1/10/2008 DynaMed’s Systematic Literature Surveillance
Williamson IG, Rumsby K, Benge S, et al. Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: A randomized controlled trial. JAMA. 2007;298(21):2487-2496.
12/11/2009 DynaMed’s Systematic Literature Surveillance
Zalmanovici A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database Syst Rev. 2009;(4):CD005149.
Last Updated: 9/30/2014