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Sinus infection and chronic sinusitis

Sinusitis is inflammation of the lining of the sinuses behind the cheekbones and forehead caused by a virus or bacterial infection.

Sinusitis symptoms include blocked or runny nose, face pain, fever and sinus headaches.

Conditions that increase the risk of sinusitis include the common cold, hayfever and other allergies, nasal polyps and cystic fibrosis.

There are different types of sinusitis including:

  • Acute sinusitis: A sudden onset of cold-like symptoms such as runny nose, stuffy nose and facial pain that typically lasts no more than a week but can last longer.
  • Chronic sinusitis: A condition characterised by sinus inflammation symptoms lasting more than 12 weeks.
  • Recurrent sinusitis: Several attacks within a year.

Who gets sinusitis and sinus infections?

Millions of people have at least one episode of sinusitis each year. People who develop the following conditions have a higher risk of sinusitis:

  • Nasal mucous membrane swelling as from a common cold
  • Blockage of drainage ducts
  • Structure differences that narrow the drainage ducts
  • Conditions that result in an increased risk of infection such as immune deficiencies or taking medications that suppress the immune system.

In children common environmental factors that contribute to sinusitis include allergies, illness from other children at day care or school, dummies, bottle drinking while lying on one's back and smoke in the environment.

In adults the contributing factors are most frequently infections and smoking.

Acute sinusitis: What are the signs and symptoms?

The primary symptoms of acute sinusitis include:

  • Facial pain/pressure
  • Nasal stuffiness
  • Nasal discharge
  • Loss of smell
  • Cough/congestion

Additional symptoms may include:

Acute sinusitis may be diagnosed when a person has two or more symptoms and/or the presence of thick, green or yellow nasal discharge.

Chronic sinusitis: What are the signs and symptoms?

People with chronic sinusitis may have the following symptoms for 12 weeks or more:

  • Facial congestion/fullness
  • A nasal obstruction/blockage
  • Pus in the nasal cavity
  • Nasal discharge/discoloured postnasal drainage

Additional symptoms may include:

How is sinusitis and sinus infection diagnosed?

To diagnose sinusitis your GP will review your symptoms and give you a physical examination.

The examination may include the doctor feeling and pressing your sinuses for tenderness. The doctor may also tap your teeth to see if you have an inflamed paranasal sinus.

Other diagnostic tests may include a study of the mucus culture, nasal endoscopy (see below), X-rays, allergy testing, CT scan of the sinuses and blood tests.

What is nasal endoscopy?

A nasal endoscope is a special tube-like instrument equipped with tiny lights and cameras used to examine the interior of the nose and sinus drainage areas.

A nasal endoscopy allows your doctor to view the accessible areas of the sinus drainage pathways. Your nasal cavity may first be numbed using a local anaesthetic (some cases do not require any anaesthetic). A rigid or flexible endoscope is then placed in position to view the middle bone structure of the nasal cavity.

The procedure is used to observe signs of obstruction as well as detect nasal polyps hidden from routine nasal examination. During the endoscopic examination the doctor also looks for any structural abnormalities that would cause you to experience recurrent sinusitis.

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