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Department of Otolaryngology
 

Sinusitis

Conditions We Treat


​Sinusitis refers to inflammation of the sinuses. Sinuses are hollow cavities in the face and skull which produce mucus. These sinuses include the ethmoid (located between the eyes), maxillary (located in the cheeks), sphenoid (located behind the eyes) and frontal (located in the forehead) sinuses. Normally, the mucus produced by the sinuses drains into the nasal cavity. However, when an obstruction is present mucus and pressure can build up, allowing for bacterial growth. Cilia are finger-like projections in the mucous membranes that sweep away mucus, bacteria or other debris. If they are not functioning, these particles are not cleared and symptoms can present. Sinusitis is more commonly called rhinosinusitis, due to the involvement and inflammation of the nasal cavity in addition to the sinuses. There are several different forms of sinusitis: acute, subacute and chronic sinusitis.

Acute sinusitis normally lasts from 1 day to 4 weeks. Acute rhinosinusitis most frequently results from viral infection, but may occur from bacterial infection as well. Subacute rhinosinusitis is a sinus infection that ranges in duration from 4 weeks to 3 months. It is often treated in the same method as acute sinusitis. Chronic rhinosinusitis is defined by symptoms that last longer than 3 months.

Different symptoms present themselves depending on the location of the infection or inflammation. Maxillary sinusitis presents with pain or tenderness behind the cheek bones or in the upper teeth, congestion, and purulent drainage. Frontal sinusitis is characterized by pain or pressure in the forehead, which is sometimes described as a headache. Ethmoid sinusitis presents with nasal congestion, pain or pressure around the eye, drainage, decreased sense of smell, and possibly pressure or headache. Sphenoid sinusitis presents deep-seated headache and postnasal drainage, but may be severe enough to cause fever or vision disturbances.

The main method in treating acute sinusitis is antibiotics, since many of the infections are bacterial. To relieve the symptoms, the physician may prescribe nasal saline rinses or nasal corticosteroids to reduce the inflammation. Decongestants may also be helpful to control symptoms. In chronic sinusitis, the mainstays of therapy include saline rinses and topical steroids, with some benefit being gained from antibiotics and oral steroids.​