Sinusitis

Especially in the springtime, patients will come to the office with sinus symptoms. Sinusitis is the medical term for inflammation of the lining of the sinuses and nose. The sinuses are the hollow areas within the facial bones that are connected to the inside of the nose. It’s not easy to determine if the patient is suffering from seasonal allergies or has an infection.
 

The most common cause of acute sinusitis is a viral infection associated with the common cold. Bacterial sinusitis occurs much less commonly, in only 0.5 to 2 percent of cases, usually as a complication of viral sinusitis. The correct antibiotic can seem like a miracle cure but antibiotics are only effective against bacteria. An acute bacterial infection can be suspected if the patient has been sick for more than ten days without improvement, has a fever greater than 102 degrees or was initially getting better and then got suddenly worse.

 

Patients who have symptoms for fewer than ten days without a fever should have supportive care. This includes pain relief with acetaminophen or ibuprofen, saline nasal irrigation and fluids. Breathing up steam can be very helpful. Medications to thin secretions (such as guaifenesin) may help to clear mucus. Decongestants are usually not helpful and can have side-effects. Antihistamines only work if there is an allergic component. Nasal steroids (steroids delivered by a nasal spray) can help to reduce swelling inside the nose. These prescription medications have few side effects and dramatically relieve symptoms in most people.

 The vast majority of patients will eventually get better without medical intervention, but we do have products that can make people feel better much faster. Usually a quick exam will point the patient in the right direction.