Sinus Infection

What is sinusitis?

• Acute bacterial sinusitis is an infection of the sinus cavities caused by bacteria
• It usually is preceded by a cold, allergy attack, or irritation by environmental pollutants
• Unlike a cold, or allergy, bacterial sinusitis requires a doctor’s diagnosis and treatment with an antibiotic to cure the infection and prevent future complications

Sinus symptoms

• Facial pain and pressure – sinus pain
• Nasal discharge that is whitish or coloured – thick yellow-green nasal drainage
• Ear infection
• Fever
• Headache
• Nasal congestion and blockage
• Bad breath
• Pain in the upper teeth
• Coughing
• Post-nasal drip, sometimes leading to sore throat, cough, bad breath and nausea
• Eye symptoms such as swelling around the eyes
• Symptoms present for more than 10-14 days

What is the difference between a cold and sinusitis?

• Normally, mucus collecting in the sinuses drains into the nasal passages
• When you have a cold or allergy attack, your sinuses become inflamed and are unable to drain – this can lead to congestion and infection
• Your doctor will diagnose acute sinusitis if you have up to 4 weeks of purulent nasal drainage accompanied by nasal obstruction, facial pain-pressure-fullness, or both
• The sinus infection is likely bacterial if it persists for 10 days or longer, or if the symptoms worsen after an initial improvement

Chronic sinus infection – When does acute sinusitis become chronic?

• When you have frequent sinusitis, or the infection lasts three months or more, it could be chronic sinusitis
• Symptoms of chronic sinusitis may be less severe than those of acute; however, untreated chronic sinusitis can cause damage to the sinuses that sometimes requires surgery to repair

Sinus infection treatment

• Sinus infection remedies

  • An oral or nasal spray or drop decongestant may be recommended to relieve congestion, although you should avoid prolonged use of over the counter nasal sprays or drops
  • Inhaling steam or using saline nasal sprays or drops can help relieve sinus discomfort

• Sinus infection antibiotics

  • Therapy for bacterial sinusitis should include an appropriate antibiotic
  • If you have symptoms of sinusitis be sure to see your doctor for diagnosis

• What about antibiotic resistance

  • Antibiotic resistance means that some infection-causing bacteria are immune to the effects of certain antibiotics prescribed by your doctor
  • Antibiotic resistance is making even common infections, such as sinusitis, challenging to treat
  • You can help prevent antibiotic resistance – one way is to wait up to 7 days before taking antibiotics for mild sinus infections, allowing time for your body to fight the infection naturally
  • If your doctor prescribes an antibiotic, it is important that you take all of the medication just as your doctor instructs, even if your symptoms are gone before the medicine runs out

• Intensive antibiotic therapy

  • If your doctor thinks you have chronic sinusitis, intensive antibiotic therapy may be prescribed
  • Surgery is sometimes necessary to remove physical obstructions that may contribute to sinusitis

• When to operate – Endoscopic sinus surgery

  • Surgery should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications or where complications of sinusitis develop
  •  The type of surgery is chosen to best suit the patient and the disease

• Endoscopic sinus surgery

  • ESS is recommended for certain types of sinus disease
  • With the endoscope, the surgeon can look directly into the nose, while at the same time, removing diseased tissue and polyps and clearing the narrow channels between the sinuses and opening the nasal passages
  • Before surgery, be sure that you have realistic expectations for the results, recovery, and postoperative care
  • Good results require not only good surgical techniques, but a cooperative effort between the patient and ENT surgeon throughout the healing process
  • It is equally important for patients to follow pre- and postoperative instructions

When should a doctor be consulted?

• Because the symptoms of sinusitis sometimes mimic those of colds and allergies, you may not realize you need to see a doctor
• If you suspect you have sinusitis, review these signs and symptoms
• If you suffer from three episodes of sinusitis or more, you should see your doctor

Can children suffer from sinus infections?

• Your child’s sinuses are not fully developed until age 20
• However, children can still suffer from sinus infection
• Although small, the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth
• Sinusitis is difficult to diagnose in children because respiratory infections are more frequent, and symptoms can be subtle
• Unlike a cold or allergy, bacterial sinusitis requires a doctor’s diagnosis and treatment with an antibiotic to prevent future complications

Children’s sinus symptoms – The following symptoms may indicate a sinus infection in your child:

• A “cold” lasting more than 10 to 14 days, sometimes with low-grade fever
• Thick yellow-green nasal drainage
• Post-nasal drip, sometimes leading to or exhibited as sore throat, cough, bad breath, nausea and/or vomiting
• Headache, usually not before age 6
• Irritability or fatigue
• Swelling around the eyes

If these symptoms persist despite appropriate medical therapy, care should be taken to seek an underlying cause. The role of allergy and frequent upper respiratory infections should be considered.

Tips to prevent sinusitis

• As always, prevention is the key – to avoid developing sinusitis during a cold or allergy attack, keep your sinuses clear by:
  • Using an oral decongestant or a short course of nasal spray decongestant
  • Gently blowing your nose, blocking one nostril while blowing through the other
  • Drinking plenty of fluids to keep nasal discharge thin
  • Avoiding air travel whilst you have a cold or sinus infection – if you must fly, use a nasal spray decongestant before take-off to prevent blockage of the sinuses allowing mucus to drain
  • If you have allergies, try to avoid contact with things that trigger attacks – if you cannot, use over-the-counter or prescription antihistamines and/or a prescription nasal spray to control allergy attacks
  • Allergy testing, followed by appropriate allergy treatments, may increase your tolerance of allergy-causing substances