Sinusitis

Acute Sinusitis




Acute Sinusitis

What Is It?

Sinuses are air-filled spaces behind the bones of the upper face:
between the eyes and behind the forehead, nose and cheeks. The lining of
the sinuses are made up of cells with tiny hairs on their surfaces
called cilia. Other cells in the lining produce mucus. The mucus traps
germs and pollutants and the cilia push the mucus out through narrow
sinus openings in the nose.
When the sinuses become inflamed or infected, the mucus thickens and
clogs the openings to one or more sinuses. Fluid builds up inside the
sinuses, causing increased pressure. Also, bacteria can become trapped,
multiply and infect the lining. This is sinusitis. Sinusitis is either
chronic (long-lasting or frequently returning) or acute, lasting three
weeks or less and happening no more than three times per year). Acute
sinusitis is extremely common. It affects about 14% of people in the
United States every year. It usually is caused by an upper respiratory
viral infection.
The inflammation and swelling of the lining of the sinuses can be
triggered by:
Viral infections, such as a common cold
Allergies
Air pollution and cigarette smoke
Dental infections
Narrowed nasal passages from nasal polyps Symptoms
Common symptoms of acute sinusitis include nasal congestion (think green
nasal discharge), fever, headache, tiredness and facial pain. Some
symptoms depend on which sinus is inflamed. For example: Frontal
sinusitis (behind the forehead) can cause pain in the forehead and pain
that gets worse when lying on your back. Ethmoid sinusitis (behind the
bridge of the nose) can cause pain between the eyes, eyelid swelling,
loss of smell and pain when touching the sides of the nose.
Sphenoid sinusitis (behind the eyes) can cause earaches, neck pain, or
headache at the top of the head or deep behind the forehead. Maxillary
sinusitis (behind the cheeks) can cause pain in the cheeks, under the
eyes, or in the upper teeth and jaw Diagnosis
A sinus infection can be difficult to diagnose in the early stages
because it can mimic a common cold. Both can cause nasal congestion and
fatigue. However, a common cold usually will improve in five to seven
days, while an untreated sinus infection can last three weeks or longer.
Sinus infections also are more likely to cause a green nasal discharge,
fever and facial pain.
Your doctor will diagnose acute sinusitis based on your symptoms,
medical history and a simple office examination. The doctor will ask
about your symptoms and how long they last, look into your ears, nose
and throat, and may tap or press on your face to test for tenderness
over specific sinuses.
If your doctor is uncertain of your diagnosis, he or she may use other
methods to see inside the sinuses. Some physicians may insert a
nasopharyngoscope (a thin, lighted tube with a camera on the end) into
your nose to look for abnormalities. X-rays and computed tomography
scans also can provide a look at the sinuses, especially those that are
deep within the head.
Expected Duration
Most acute sinus infections respond to treatment or improve on their own
within three weeks. Infections that last longer than three weeks are
considered chronic sinusitis.
Prevention
There are some measures you can take to decrease your risk of developing
sinusitis. If you smoke cigarettes, you should quit, because smoke can
irritate nasal passageways and increase the likelihood of infection.
Chronic nasal allergies can trigger sinus infections, too. If you
suspect you have an allergy to mold or pollen, talk to a doctor about
allergy treatments.
If you have congestion from a cold or allergies, the following may help
to reduce the risk of developing sinusitis: Drink lots of water. This
thins nasal secretions and keeps mucous membranes moist.
Use steam to soothe nasal passages. Breathe deeply while standing in a
hot shower, or inhale the steam from a pan of hot water while holding a
towel over your head but don't get too close; steam can burn. Avoid
blowing your nose with great force, which can push bacteria into the
sinuses.
Treatment
Many sinus infections improve without treatment. However, several
medications may speed recovery and reduce the chance that an infection
will become chronic.
Decongestants -- Congestion often triggers sinus infections, and
decongestants can open the sinuses and allow them to drain. Several are
available:
Pseudoephedrine (Sudafed) is available without prescription, alone or in
combination with other medications in multi-symptom cold and sinus
remedies. Pseudoephedrine can cause insomnia, racing pulse and
jitteriness. Do not use if you have high blood pressure or a heart
condition. Phenylephrine (Sudafed PE and others) is an alternative
over-the-counter oral decongestant. If you take products containing oral
phenylephrine, check with the pharmacist to be certain there is no
interaction with other medications you take. Oxymetazoline (Afrin,
Dristan and others) and phenylephrine (Neo-Synephrine and others) are
found in nasal sprays. They are effective and may be less likely to
cause the side effects seen with pseudoephedrine. However, using a nasal
decongestant for more than three days can cause worse symptoms when you
stop the medication. This is called the rebound effect.
Antihistamines -- These medications help to relieve the symptoms of
nasal allergies that lead to inflammation and infections. However, some
doctors advise against using antihistamines during a sinus infection
because they can cause excessive drying and slow the drainage process.
Over-the-counter antihistamines include diphenhydramine (Benadryl and
others), chlorpheniramine (Chlor-Trimeton and others) and loratadine
(Claritin). Fexofenadine (Allegra) and cetirizine (Zyrtec) are available
by prescription.
Nasal steroids -- Anti-inflammatory sprays such as mometasone (Nasonex)
and fluticasone (Flonase), both available by prescription, reduce
swelling of nasal membranes. Like antihistamines, nasal steroids can be
most useful for those who have nasal allergies. Nasal steroids tend to
be less drying than antihistamines, and unlike nasal decongestants,
nasal steroids can be used for prolonged periods. Saline nasal sprays --
These salt-water sprays are safe to use and can provide some relief by
adding moisture to the nasal passages, thinning mucus secretions and
helping to flush out any bacteria that may be present.
Pain relievers -- Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin
and others) can be taken for headache or sinus pain, and they may reduce
some inflammation.
Antibiotics -- Your doctor may prescribe an antibiotic if he or she
suspects that a bacterial infection is causing your sinusitis.
Antibiotics help to kill bacteria and control infection. If you start
taking an antibiotic, complete the entire course so that the infection
is completely killed off. Not all cases of sinusitis require antibiotic
treatment. Talk with your doctor about whether an antibiotic is right
for you. Keep in mind that antibiotics can cause side effects, such as
allergic reactions, rash and diarrhea. In addition, overusing
antibiotics eventually leads to the spread of bacteria that no longer
can be killed by the most commonly prescribed antibiotics. When To Call
A Professional
Contact a doctor if you experience facial pain along with a headache and
fever, cold symptoms that last longer than 7 to 10 days, or persistent
green discharge from the nose. If your symptoms don't improve within a
week of beginning treatment, call your doctor for follow-up. If you have
repeated bouts of acute sinusitis, you may have allergies or another
treatable cause of sinus congestion. Ask your doctor for advice.
Prognosis
The prognosis for acute sinusitis is very good. Most cases will go away
within one to two weeks, often without antibiotics. Bacterial sinus
infections treated with antibiotics may clear up more quickly. *
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Donna G.
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ANGELS EXIST, but some times, since they don't all have wings, we call
them FRIENDS......