What is a sinus infection?
Hello, my name is Dr. Priscilla Bresler and I'm an internal medicine doctor at The Ohio State University Wexner Medical Center. A common problem that we manage here is sinusitis. Sinusitis is a swelling, or inflammation, of the tissues lining the sinuses. Let's start by briefly reviewing the anatomy. The nose and sinuses are interconnected so we often refer to sinusitis as rhinosinusitis, and to the sinuses as paranasal sinuses. Paranasal sinuses are hollow spaces in the bones of the face that surround the nose and eyes. There are four pairs of sinuses; and they are located in the cheekbones, in the forehead above the eyes, between the eyes under the nasal bridge and deeper in the skull.
The paranasal sinuses are connected to the nasal cavity by small openings called ostia, which provide a passageway for mucus to drain from the sinuses into the nose. So what is sinusitis or rhinosinusitis, as it is also known? It is an inflammation of the nasal cavity and paranasal sinuses associated with swelling and mucus production. Sinusitis may be acute, recurrent or chronic. Acute sinusitis usually starts with an upper respiratory viral infection such as the common cold. In most cases, cold symptoms resolve within 7 - 10 days without treatment.
However, sometimes inflammation and swelling from the cold cause blockage of the ostia, so mucus forming in the sinuses cannot drain. This mucus that is now trapped in the sinuses is a nourishing environment for bacteria to grow and flourish resulting in a bacterial infection. So instead of feeling better 10 - 14 days after the cold started, symptoms of a secondary infection are setting in and making you feel worse. Recurrent sinusitis is when there are multiple, distinct episodes of acute sinusitis per year.
Acute sinus infections often go away without an antibiotic. Monitoring symptoms while using over the counter remedies is a reasonable approach to managing a sinus infection. However, when the infection is severe or is not improving after one to two weeks, an antibiotic may be needed. Chronic sinusitis occurs when inflammation in the sinuses persists despite treatment and it is much less common than acute sinusitis.
The hallmark is that the symptoms last for at least three months. Chronic sinusitis is not always caused by infection, although infection may aggravate it. Other potential triggers include inflammation from allergies, tobacco smoke and other similar irritants and anything that obstructs drainage from the sinus cavities. To confirm the diagnosis of chronic sinusitis, you may need a CAT scan or visit to an Ear, Nose and Throat specialist. For more information, visit csh.osu.edu or call 614-293-2076.
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