Alabama Allergy & Asthma Center

Sinusitis

Sinusitis is an inflammation or infection of one or more of the sinuses that drain into the nose. The lining of the nose and sinuses produce a protective layer of mucus to trap bacteria and inhaled particles. Tiny hairs called "cilia" project from the nasal and sinus lining and clear mucus from the sinuses.

Sinusitis often occurs when the lining of the nose and sinuses becomes inflamed and swollen thereby blocking one or more openings that allow the sinuses to drain. Additionally, the cilia are unable to clear mucus from the sinuses. When the mucus cannot drain properly, it builds up in the sinus, allowing bacteria to multiply and cause an infection.

People with allergies are more likely to have problems with sinusitis because of the swelling and inflammation that can block the nose and sinuses. Viruses, such as colds or flu, and enlarged adenoids or polyps may also cause a blockage that prevents adequate sinus drainage. This increases the chance for sinusitis.

Sinusitis and Asthma

Chronic sinusitis may complicate asthma because of the chronic inflammation that can affect the entire airway including the nose and the lungs. An asthmatic with sinusitis may show peak flows that drop into the Yellow Zone. You may not have an acute asthma episode, but if you have a case of sinusitis, you may be more susceptible to exercise and irritant triggers. A sinus infection is often at the root of recurrent asthma attacks; preventing and controlling sinus disease is a key to managing asthma.

Do I Have a Sinus Infection?

Allergies are the most common cause of recurrent or chronic sinusitis and it might be difficult sometimes to differentiate between the two. Some of the chronic symptoms include:

• Nasal congestion
• Several days of green or yellow nasal discharge
• Post-nasal drip
• Persistent cough, especially in the early morning or at night
• Bad breath
• Recurrent sinus headaches
• Dark circles or swelling under the eyes
• Sinus pressure
• Toothaches or facial pain
• Frequent asthma episodes

If sinusitis is suspected, it is important that the ears, nose, and lungs are examined. Some people may have chronic sinusitis lasting for several months or more, with recurrent flare-ups. Your doctor may suggest a CT scan to view the sinuses more effectively. The doctor may perform a rhinoscopy where a small, flexible tube with fiber optics is placed inside the nose to view the sinuses, throat, and vocal cords.

Treatment

If the diagnosis of chronic sinusitis has been made, antibiotics are usually ordered for at least three weeks. A follow-up CT scan may be necessary to make sure the infection has completely cleared. Many allergy and sinus specialists will not order the first CT scan until at least a three to four week course of antibiotics has been tried. Decongestants, saline irrigations, and corticosteroid nasal sprays also may be used. For people with allergies, it is important to keep the allergies well controlled with avoidance measures, medication, and allergy injections for desensitization if necessary. Also, be sure that you keep asthma controlled by using the medications outlined by your asthma care plan.