In the facial bones surrounding your nose, there are four pairs of hollow air spaces known as sinuses or sinus cavities. These sinuses all open into your nose, allowing air to move into and out of the sinus and mucous to drain into the nose and the back of your throat. If the passage between the nose and sinus becomes swollen and blocked, then air and mucous can become trapped in the sinus cavity causing inflammation of the sinus membranes or linings. This is known as sinusitis.
Sinusitis can be:
- acute - usually a bacterial (or sometimes viral) infection in the sinuses that follows a cold, or an allergic reaction.
- chronic - a long term condition that lasts for more than 3 weeks and may or may not be caused by an infection.
Sinusitis can be a recurrent condition which means it may occur every time you get a cold.
Symptoms of sinusitis include:
- facial pain or pressure
- nasal congestion (blocking)
- nasal discharge
Most sinusitis will respond to medication but a sinus infection is similar to an abscess. As such prolonged courses of antibiotics are required: 2 – 3 weeks for acute sinusitis and 4 – 6 weeks for chronic sinusitis. Broad spectrum antibiotics such as Doxycycline, Roxithromycin, Amoxil, Augmentin or Co-Trimoxazole are appropriate. To decrease inflammation and improve drainage, oral steroids (Prednisone) for 14 - 21 days and topical decongestants can be useful. Oral decongestants and antihistamines have not been proven to be beneficial.
Those who fail medical therapy become candidates for surgery. If surgery is contemplated a CT scan of the sinuses will be required. Most sinus surgery is performed endoscopically - through the nostrils. The aim is to drain any infection and to imprve the ventilation and subsequent drainage of the sinuses.