Sinusitis is inflammation of the linings of the sinuses - the air-filled spaces in your skull behind the bones of your face and forehead. The maxillary sinuses in each cheekbone are most commonly affected by sinusitis which can be short or long-term. Sinusitis lasting a few days to a few weeks is called acute sinusitis but if it lasts three months or more it is known as chronic sinusitis and can affect people of any age. Most bouts of acute sinusitis are caused by an infection such as a cold whereas chronic sinus problems are usually linked to something that regularly irritates the lining of the nose such as infection, pollen, overuse of decongestant nose sprays and allergies.
These are the four pairs of cavities (air-filled spaces) known as paranasal sinuses in the head. These small hollow spaces, which are located within the skull or bones of the head surrounding the nose, are named for the bones that contain them, namely:
Frontal sinuses over the eyes in the brow area.
Maxillary sinuses inside each cheekbone.
Ethmoid sinuses just behind the bridge of the nose, between the eyes.
Sphenoid sinuses behind the ethmoids in the upper region of the nose and behind the eyes.
The paranasal sinuses open into the nasal cavity and are lined with cells that make mucus to keep the nose from drying out during breathing and to trap unwanted materials so that they do not reach the lungs.
The main symptom of sinusitis is a throbbing pain and pressure in the face, which is worse bending forwards. There may be pain above the eyebrows, the forehead may be tender to touch and you may feel as if you have toothache in the upper teeth. Other typical symptoms include a blocked nose, headaches, and reduced sense of smell. Because your nose can get stuffy or congested when you have a condition like the common cold, you may confuse simple nasal congestion with sinusitis. A cold usually lasts about 7 to 14 days and goes away without treatment, whereas acute sinusitis often lasts longer and typically causes more symptoms than a cold.
Sinusitis is most commonly caused by viral infections, and only a small proportion of infections are bacterial. Other than infections, causes include allergies, smoking, and – for the more adventurous among you – climbing at altitude.
Because the most common causes are viral, the condition normally improves or resolves by itself within two to three weeks. Viruses don't respond to antibiotics, so they don't usually have a role in treating sinusitis.
Simple steps can help you back to recovery. Painkillers such as paracetamol and ibuprofen are a good place to start. You can also try saline rinses or sprays to clear the nose of mucus and remove other debris, or steam inhalation.
Steroid nasal sprays can help to reduce irritation and inflammation in the nasal passages and sinuses. Steroid nasal sprays don’t work immediately, they can take one to two weeks to work, so best to be patient. Decongestant sprays or tablets can help alleviate congestion.
Quitting smoking will help heal your sinuses, if this applies to you and is a good incentive.
Air travel may pose a problem if you suffer from acute or chronic sinusitis. When air pressure in a plane is reduced, pressure can build up in your head, blocking your sinuses or the eustachian tubes (the airways between the middle ear and the back of the throat that equalize air pressure on either side of the eardrum). As a result, you might feel discomfort in your sinuses or middle ear during the plane’s ascent or descent. Try using decongestant nose drops or sprays before a flight to avoid this problem
If you have had symptoms for more than two to three weeks then it would be worth speaking to your doctor. You should also speak to your doctor if you have severe symptoms such as high fever, or severe pain, or you are not clear of the cause of your symptoms.
These symptoms fit more with bacterial sinus infection: one-sided facial pain or tenderness especially over your teeth or jaw, yellow-green mucus coming from your nose, and symptoms lasting for more than two to three weeks. Your doctor may consider prescribing antibiotics if they feel it is more likely to be bacterial than viral, and symptoms are not improving. Bacterial sinusitis also often resolves on its own but it can take a lot longer than two to three weeks. Sometimes antibiotics are required to treat it.
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