Topic of the Month: November 2003: Sinusitis

In this month's issue you will:
Learn about Sinusitis
Know the difference between the common cold and sinusitis
Read about different types of sinusitis

Have you ever had cold symptoms that lasted more than several days? If so, chances are you may have had acute sinusitis, an inflammation of the nasal sinuses. Experts estimate that 31 million people develop sinusitis each year, making it one of the most common health conditions in America. That is one reason why it is extremely important to learn about the signs and symptoms of sinusitis.

Definition of sinusitis

Sinusitis is an acute or chronic inflammation of the nasal sinuses-the hollow cavities found within the cheek bones and near the eyes. The inflammation is usually triggered by inadequate draining due to allergies, infections, or structural problems of the nose, such as narrow drainage passages or a deviated septum. Sinuses help warm, moisten and filter the air in the nasal cavity. A sinusitis condition can interfere with one's lifestyle because of the constant pain and discomfort.

Symptoms of Sinusitis

Symptoms of sinusitis may include:
profuse, thick, colored nasal drainage,
bad tasting post-nasal drip,
cough,
head congestion/headache,
a plugged up nose,
a feeling of facial swelling,
toothache,
constant tiredness, and
occasionally a fever.

Sinusitis vs. the Common Cold
The signs and symptoms of sinusitis are sometimes mistaken or confused with those of a common cold. You may suffer from sinusitis and may not be aware you have it or realize you need to see a doctor. If you suspect you have sinusitis, review these signs and symptoms.

Signs/Symptoms	Sinusitis	Cold
In most cases is caused by bacterial infection	Over 10-14 days	Under 10 days
Tiredness and Weakness	Mild	Can last two or more weeks
Extreme exhaustion	Never	Sudden onset and can be severe
Runny nose	Often	Sometimes
Sneezing	No	Yes
Sore throat	No	Yes
Cough	Sometimes	Yes, can become severe
Facial Pressure/Pain	Yes	Sometimes
Headache	Sometimes	Sometimes
Nasal Discharge	Thick, Yellow-Green	Thin, White
Nasal Congestion	Yes	Yes
Fever	Sometimes	Sometimes

If you suffer from some or most of these symptoms, please see your physician; you may be suffering from sinusitis. Proper diagnosis and management of sinusitis requires a physician who recognizes the signs and symptoms. Once sinusitis is diagnosed, the physician and/or allergist can work together to provide you with an effective management and treatment plan. There are many types of physicians who treat sinusitis, including:

allergists/immunologists;
family physicians;
general practitioners;
internists; and
pediatricians.

Different Types of Sinusitis

Understanding the difference between "acute sinusitis" and "chronic sinusitis" is important. Both conditions generally require different treatments.

 

Signs/Symptoms	Acute Sinusitis	Chronic Sinusitis
In most cases is caused by bacterial infection	X
Occurs as a late complication of a common cold	X
Chronic inflammatory disorder		X
Symptoms persist for more than 12 weeks		X
Discomfort in the cheeks, forehead or around the eyes	X	X
Cough	X	X
Pain in the upper teeth	X	X
Headache	X	X
Thick nasal or postnasal drainage	X	X
Nasal congestion	X	X
Slight fever	X

After taking a medical history and conducting a physical examination, your allergist should be able to diagnose whether you have acute or chronic sinusitis. Your allergist can help you manage your sinusitis. He or she can determine if you have an allergic disease that is contributing to your condition. A trained allergist will determine what triggers your symptoms, as well as other triggers which may be causing sinus obstruction. Then your allergist will make recommendations on how to treat this disorder.

Treatment
Antibiotics are sometimes prescribed, however may not always be necessary for sinusitis. Decongestants and corticosteroid nasal sprays are often used in combination of the other medication. Allergists also recommend several non-drug treatments such as breathing in hot, moist air; applying hot packs to the face and washing the nasal cavities with buffered salt water. In certain cases, endoscopic surgery to correct structural problems of the nose may be needed in more serious cases of chronic sinusitis. If there is the possibility of surgery to correct the sinusitis, your allergist will be able to make the proper referral to a surgeon.

Sinusitis Statistics
Sinusitis develops in approximately 31 million Americans each year. "Parameters for the Diagnosis and Management of Sinusitis." Journal of Allergy and Clinical Immunology (1998) 102:S107-S144.

People suffering from sinusitis miss an average of four days of work each year. "Parameters for the Diagnosis and Management of Sinusitis." Journal of Allergy and Clinical Immunology (1998) 102:S107-S144.

There is an association between sinusitis and asthma. The incidence of sinusitis in asthmatic subjects ranges from 40 to 75%. "Parameters for the Diagnosis and Management of Sinusitis." Journal of Allergy and Clinical Immunology (1998) 102:S107-S144.

This topic was reviewed on 11-01-03 for medical accuracy by Stuart A. Friedman, MD, FAAAAI, Patients and Consumers Center Editor.