Sinus Infections

Sinus Infections

Sinus infection, or sinusitis, is an inflammation of the sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough,sore throat, fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type).


Sinusitis is very common. In 2009 there were 29.3 million adults diagnosed with sinusitis in the United States. In 2007 there were 12.5 million visits to health practitioners for chronic sinusitis alone.


Here is an overview of the anatomy of the sinuses (also called paranasal sinuses). The human skull contains four major pairs of hollow air-filled-cavities called sinuses. These are connected to the space between the nostrils and the nasal passage (behind your nose). Sinuses help insulate the skull, reduce its weight, and allow the voice to resonate within it.


The four major pairs of sinuses are the:


  1. frontal sinuses (in the forehead),
  2. maxillary sinuses (behind the cheek bones),
  3. ethmoid sinuses (between the eyes),
  4. sphenoid sinuses (behind the eyes),
  5. the sinuses contain defenses against viruses and bacteria (germs). The sinuses are covered with a mucous layer and cells that contain tiny hairs on their surfaces (cilia). These help trap and propel bacteria and pollutants outward,
  6. acute sinusitis usually lasts less than eight weeks or occurs no more than three times per year with each episode lasting no longer than 10 days. Medications are usually effective against acute sinusitis. Successful treatment counteracts damage done to the mucous lining of the sinuses and surrounding bone of the skull,
  7. chronic or recurring sinusitis lasts longer than eight weeks or occurs more than four times per year with symptoms usually lasting more than 20 days.


Signs and symptoms of sinus infections depend upon which sinuses are affected and whether the sinus infection is acute or chronic.


Acute sinusitis:


  • Ethmoid sinusitis (behind the eyes).
  1. Nasal congestion with discharge.
  2. Postnasal drip (mucus drips down the throat behind the nose) often accompanied by a sore throat.
  3. Pain or pressure around the inner corner of the eye or down one side of the nose.
  4. Headache in the temple, or surrounding or behind the eye.
  5. Pain or pressure symptoms are worse when coughing, straining, or lying on the back and better when the head is upright.
  6. Fever is common.


  • Maxillary sinusitis (behind the cheek bones).
  1. Pain across the cheekbone, under or around the eye, or around the upper teeth.
  2. Pain or pressure on one side or both.
  3. Tender, red, or swollen cheekbone (maxilla).
  4. Pain and pressure symptoms are worse with the head upright and bending forward and better when reclining.
  5. Nasal discharge or postnasal drip.
  6. Fever is common.


  • Frontal sinusitis (behind forehead, one or both sides).
  1. Severe headaches in the forehead.
  2. Fever is common.
  3. Pain is worse when reclining and better with the head upright.
  4. Nasal discharge or postnasal drip.


  • Sphenoid sinusitis (behind the eyes).
  1. Deep headache with pain behind and on top of the head, across the forehead, and behind the eye.
  2. Fever is common.
  3. Pain is worse when lying on the back or bending forward.
  4. Double vision or vision disturbances if pressure extends into the brain.
  5. Nasal discharge or postnasal drip.


Chronic sinusitis:


  • Ethmoid sinusitis.
  1. Chronic nasal discharge, obstruction, and low-grade discomfort across the bridge of the nose.
  2. Pain is worse in the late morning or when wearing glasses.
  3. Chronic sore throat and bad breath.


  • Maxillary sinusitis.
  1. Discomfort or pressure below the eye.
  2. Chronic toothache or increased tooth sensitivity.
  3. Pain possibly worse with colds, flu, or allergies.
  4. Increased discomfort throughout the day with increased cough at night.


  • Frontal sinusitis.
  1. Persistent, low-grade headache in the forehead.
  2. History of trauma or damage to the sinus area.
  3. Chronic postnasal drip.


  • Sphenoid sinusitis.
  1. Low-grade general headache is common.
  2. Chronic postnasal drip.


Acute sinusitis usually follows a viral infection in the upper respiratory tract, but allergy-causing substances (allergens) or pollutants may also trigger acute sinusitis. Viral infection damages the cells of the sinus lining, leading to inflammation. The lining thickens, obstructing the nasal passage. 


This passage connects to the sinuses. The obstruction disrupts the process that removes bacteria normally present in the nasal passages, and the bacteria begin to multiply and invade the lining of the sinus. This causes the symptoms of sinus infection. Allergens and pollutants produce a similar effect.


Bacteria that normally cause acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. These microorganisms, along with Staphylococcus aureus and some anaerobes (bacteria that live without oxygen), are involved in chronic sinusitis.


Fungi are also becoming an increasing cause of chronic sinusitis, especially in people with diseases that weaken the immune system, such as AIDS, leukemia, and diabetes.


Home care can help open the sinuses and alleviate their dryness.


Promote drainage:


  • Drink plenty of water and hydrating beverages such as hot tea.
  • Inhale steam two to four times per day by leaning over a bowl of hot water (not while the water is on the stove) or using a steam vaporizer. Inhale the steam for about 10 minutes. Taking a hot, steamy shower may also work. Mentholated preparations, such as Vicks Vapo-Rub, can be added to the water or vaporizer to aid in opening the passageways.


Thin the mucus: 

Expectorants are drugs that help expel mucus from the lungs and respiratory passages. They help thin mucous secretions, enhancing drainage from the sinuses. The most common is guaifenesin (contained in Robitussin and Mucinex, for example).


Over-the-counter (OTC) sinus medications can also combine decongestants and cough suppressants to reduce symptoms and eliminate the need for the use of many prescription medications. Read label ingredients to find the right combination of ingredients or ask the pharmacist for help.


Relieve pain: 

Pain medication such asibuprofen (Motrin and Advil), aspirin, andnaproxen (Aleve) can reduce pain and inflammation. These medications help to open the airways by reducing swelling.Acetaminophen (Tylenol) can be used for pain and fever but does not help with the inflammation.


Nasal saline irrigation: 

There are several methods of nasal irrigation, and a popular remedy is the Neti-pot - a ceramic pot that looks like a cross between a small teapot and Aladdin's magic lamp.


  • Some ENT physicians recommend nasal irrigation with a Neti-pot to help clear crusting in the nasal passages. Many people with chronic sinus symptoms use the Neti-pot to alleviate congestion, facial pain and pressure, and reduce the need for antibiotics and nasal sprays.
  • Before using nasal saline irrigation, discuss it with your physician.
Enter through
Enter through