What is acute sinusitis?

A stuffed nose and pressure on our cheekbones, near the eyes, or over the forehead may mean that you have acute sinusitis.

Acute sinusitis, also called acute rhinosinusitis, is a short-term inflammation of the membranes that line your nose and surrounding sinuses. This impedes your ability to drain mucus from your nose and sinuses.

Acute sinusitis is most commonly due to a cold causing viral infection. However, it can be due to noninfectious causes as well. According to the American Academy of Otolaryngology, acute sinusitis is common. It affects around 1 in 8 adults per year.

What causes acute sinusitis?

Illnesses and conditions that can cause or lead to acute sinusitis include:

An infected tooth could also cause acute sinusitis. In rare cases, bacteria can spread from the infected tooth to the sinuses.

Who’s at risk for acute sinusitis?

The following factors can increase your risk of developing acute sinusitis:

  • intranasal allergies
  • nasal passage abnormalities, such as a deviated septum or nasal polyp
  • tobacco smoking or frequent breathing in of other pollutants
  • large or inflamed adenoids
  • spending a lot of time in a day care, preschool, or other areas where infectious germs are frequently present
  • activities that result in pressure changes, such as flying and scuba diving
  • a weakened immune system
  • cystic fibrosis

What are the symptoms of acute sinusitis?

Symptoms of acute sinusitis include:

  • nasal congestion
  • thick yellow or green mucus discharge from the nose
  • sore throat
  • a cough, usually worse at night
  • drainage of mucus in the back of your throat
  • headache
  • pain, pressure, or tenderness behind your eyes, nose, cheeks, or forehead
  • earache
  • toothache
  • bad breath
  • reduced sense of smell
  • reduced sense of taste
  • fever
  • fatigue

How is acute sinusitis diagnosed?

Diagnosing acute sinusitis usually involves a physical exam. Your doctor will gently press over your sinuses with their fingers to identify an infection. The exam may involve looking into your nose with a light to identify inflammation, polyps, tumors, or other abnormalities.

Your doctor may also perform the following tests to confirm a diagnosis:

Nasal endoscopy

Your doctor may look into your nose using a nasal endoscope. This is a thin, flexible fiber-optic scope. The scope helps your doctor identify inflammation or other abnormalities in your sinuses.

Imaging tests

Your doctor may order a CT scan or MRI to look for inflammation or other nose or sinus abnormalities. A CT scan uses rotating X-rays and computers to take detailed, cross-sectional images of your body. An MRI takes 3-D images of your body using radio waves and a magnetic field. Both these tests are noninvasive.

How is acute sinusitis treated?

Most cases of acute sinusitis can be treated at home:

  • A moist, warm washcloth. Hold it over your sinuses to ease pain symptoms.
  • A humidifier. This can help keep the air moist.
  • Saline nasal sprays. Use them several times a day to rinse and clear your nasal passages.
  • Stay hydrated. Drink plenty of fluids in order to help thin mucus.
  • Over-the-counter (OTC) nasal corticosteroid spray. Sprays such as fluticasone propionate (Flonase) can reduce intranasal and sinus inflammation.
  • OTC oral decongestant therapy. These therapies, such as pseudoephedrine (Sudafed), can dry up mucus.
  • OTC pain relievers. Pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can help relieve sinus pain.
  • Sleep with your head elevated. This encourages your sinuses to drain.

Prescription medications

Your doctor may prescribe prescription antibiotic therapy if they think you have acute bacterial sinusitis.

Allergy shots

If intranasal allergies are thought to be related to your bouts of acute sinusitis, your doctor may have you see an allergist. The allergist can see if allergy shots would help you deal with allergic sinusitis more easily.

Surgery

In some cases, surgery may be necessary to treat the underlying cause of acute sinusitis. Your doctor may perform surgery to:

  • remove nasal polyps or tumors
  • correct a deviated nasal septum
  • clean and drain your sinuses

Alternative treatment

The following alternative treatments may help relieve your acute sinusitis symptoms:

Herbs

Nasturtium herb and horseradish may be beneficial for relieving some acute sinusitis symptoms. This therapy produced a lower risk for adverse side effects compared to standard antibiotic therapy, per a German study published in 2007. Ask your doctor about safety and dosages.

Acupuncture and acupressure

While no hard scientific evidence exists to confirm their effectiveness in treating this condition, some people report that acupuncture and acupressure provide some relief for acute sinusitis caused by allergies.

What happens in the long term?

Most cases of acute sinusitis clear up with home treatment. Sometimes acute sinusitis doesn’t clear up and becomes subacute or chronic sinusitis.

According to the Cleveland Clinic, subacute sinusitis lasts four to eight weeks in duration. Chronic sinusitis can last over eight weeks. In very rare cases, acute infectious sinusitis can lead to an infection that spreads to your eyes, ears, or bones. It could also cause meningitis.

Call your healthcare provider if you experience:

  • a severe headache that doesn’t respond to medication
  • a high-grade fever
  • vision changes

These may be signs that the acute infection has spread outside your sinuses.

Can acute sinusitis be prevented?

You may be able to prevent getting acute sinusitis. Here’s how:

  • Eat a healthy diet to keep your immune system strong.
  • Avoid cigarette smoke and other air pollutants.
  • Minimize your contact with people who have acute respiratory or sinus infections.
  • Wash your hands often and before meals.
  • Use a humidifier in dry weather to help keep the air and your sinuses moist.
  • Get a yearly flu vaccine.
  • Treat allergies promptly.
  • Take oral decongestant therapy when you have nasal congestion.