Ask a Doctor: Sinusitis Symptoms and Treatment

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

Today, our team discusses sinusitis.
Prepared by: Natasha Tillett, Third Year Medical Student (University of Tennessee Health Science Center-College of Medicine)
Reviewed by: Dr. Anthony Sheyn, Pediatric ENT specialist

What is sinusitis and what causes it?

There are four spaces in both the right and left side of the head that are connected by channels called sinuses. Their job is to make mucus to help keep the nose clean from germs.

Though they’re normally filled with air, sometimes they can become inflamed and get blocked off and even filled with fluid. This is what we call sinusitis.

The blockage can keep the mucus from draining, which sometimes allows bacteria to grow and cause an infection (bacterial sinusitis).

Sinusitis is most often caused by viral infections like the common cold, but can be caused by anything that swells and blocks the sinuses such as allergies, foreign bodies, and tumors. Spending time in day care, school, allergies, drinking from a bottle while lying down and using a pacifier can increase the risk of sinusitis in kids.

Sinusitis in kids has the same impact on their health as asthma. It can also lead to lost work days for parents.

What puts me at risk for sinusitis?

• Viral infections like the common cold or SARS COV-2
• Allergies that affect your sinuses
• Asthma
• Abnormal nose structures like a deviated septum, nasal polyps or tumors
• A medical condition that affects mucous like cystic fibrosis
• A weak immune system whether from a medical condition like HIV/AIDS or immune suppressing drugs
• Smoke exposure, whether primary or secondary

Sinusitis symptoms:

• Mucus dripping down the throat (Post nasal drip)
• Nasal discharge or stuffy nose
• Facial pressure that gets worse when you bend over
• Headache and/or pain in your teeth or ears
• Changed sense of smell
• Bad breath
• Cough
• Tiredness
• Fever

How is sinusitis diagnosed?

Sinusitis can usually be diagnosed clinically by the physician simply asking about the symptoms, feeling for facial tenderness, and looking for swelling, drainage, or blockage inside the ears, nose and throat. If the physician thinks that allergies are triggering the inflammation, they may recommend an allergy skin test.

Sometimes a flexible tool with a light called an endoscope is used to visualize the inside of the nose, or a CT scan may be performed to see a detailed picture of your sinuses. If the sinusitis is persistent, a culture of the sinus discharge may be grown to see what germ is causing the inflammation.

Sinusitis treatments:

Sinusitis typically resolves on its own with resolution of the underlying cause.

Over the counter medications like saline nasal spray, nasal corticosteroids (Flonase, Rhinocort, Nasonex, etc.), decongestants, allergy medications (Benadryl, Allegra, etc.) and pain relievers (Tylenol, Advil, Motrin, aspirin, etc.) can help relieve symptoms associated with the sinusitis.

If using decongestants, make sure to only use them for a few days. Otherwise, they can cause the congestion to rebound and get worse. Check with your doctor before giving any medication to children, as some can have serious, life threatening side effects.

Antibiotics are usually not needed and are linked with side effects ranging from a rash to serious conditions like C. difficile or antibiotic resistant infections. Your doctor may suggest watching and waiting for 2-3 days to see if the symptoms improve before prescribing antibiotics.

When should I see a doctor?

Most of the time, sinusitis will resolve on its own, but contact your doctor under these conditions: your symptoms last more than ten days; your symptoms seem to improve, but then get worse; your fever lasts for more than three days; you have a history of chronic or recurrent sinusitis.

Immediately see a doctor if you become confused, have a high fever, vision changes, a stiff neck, or pain, swelling or redness around your eyes. Immediately see a doctor if your child is less than 3 months old and has a fever greater than 100.4 degrees Fahrenheit.

How can our Dream Team help?

Our pediatric specialist, Dr. Anthony Sheyn, has wide-ranging expertise in treating ear, nose, and throat issues. If you have concerns about your sinusitis symptoms, please contact our office to schedule an evaluation: 901-287-7337

Also, if you’d like to learn more about sinusitis, feel free to browse these posts from our archives!