Sinusitis means infection or inflammation of the sinuses. The sinuses are air-filled spaces within the bones of the face. They are located in the cheeks (maxillary), forehead (frontal) and around the eyes (ethmoidal). The sinuses are linked together, and connected to the nose and throat, via narrow channels called ostia. One function of the sinuses is to warm and moisten inhaled air before it reaches the lungs. The sinuses are also lined with cells that help prevent infection by producing mucus to trap particles of dirt and other pollutants that are breathed in.

Causes of sinusitis
Sinusitis is caused by too much mucus, or a swelling of the lining of the sinuses and nose, which can block the narrow channels. This can occur during a cold, or may be due to allergy (for example, hayfever) or irritation of the linings of the sinuses (for example, from chlorine in a swimming pool). Bacteria (germs) then grow inside the sinuses, causing pain, headache and sometimes fever. Mucus from infected sinuses can be yellow or green. Some people get sinusitis with most colds, while others get it rarely.

Symptoms
Common symptoms of sinusitis include:

• Blocked nose
• Feeling of pressure inside the face
• Facial pain, particularly when leaning forward
• Headache
• Aching teeth in the upper jaw
• Yellow or green-coloured mucus from the nose
• Swelling of the face
• Loss of the senses of smell and taste
• Persistent cough
• Generally feeling unwell.

Risk factors
Certain factors increase a person’s susceptibility to sinusitis, including:

• Frequent colds (especially for young children)
• Cigarette smoking (active or passive)
• Regular use of nasal decongestant sprays (for more than two to three days)
• Untreated hay fever or other allergies
• Structural abnormalities of the nose
• Nasal polyps (swellings in the linings of the nose or sinuses)
• Dental disease, such as untreated tooth abscess.

Complications of chronic sinusitis
Some people are troubled by frequent sinus infections, or continuous infection. Chronic sinusitis can linger for weeks or even months at a time. This can sometimes lead to serious complications, including infections in the bones and tissue near to the sinuses. Very rarely this infection can spread to the brain and the fluid around the brain. The person will be very ill and have swelling around the eyes.

People with chronic sinusitis may have other problems which affect the nose, throat and ears at the same time, including:

• Middle ear infection and temporary deafness
• Post-nasal drip (fluid from the sinuses and nose constantly drips down the back of the throat), which can lead to constant coughing, a sore throat and bad breath.

Treatment options
Decongestants that help with symptoms of colds usually do not help with sinusitis. Nose sprays can even make the problem worse, if they are used for too long, because they can cause more swelling. Antibiotics are often prescribed for sinusitis. Most people will recover fully from sinusitis in a week or so without antibiotics, but they may recover more quickly if effective antibiotics are used. (Some antibiotics are much more useful for sinusitis than others).

Other options to manage the symptoms of sinusitis include:

• Steam inhalation, perhaps including a few drops of eucalyptus oil
• Comfortably hot compresses held against the face
• Pain relief medication, such as paracetamol.

If you suffer from sinusitis, it’s important to see if there is any trigger which can be treated. For example, hayfever or dental disease may need to be treated, or you may want to avoid irritants by staying out of swimming pools.

Surgery to drain the pus and improve the flow of mucus from the sinus may be an option for persistent cases of sinusitis.

Where to get help

• Your doctor
• Chemist.

Things to remember

• Sinusitis means infection or inflammation of the sinuses, which are air-filled spaces inside the bones of the face.
• Symptoms include yellow or green-coloured mucus draining from the nose, facial pain and headache.

Last reviewed: March 2007