What is Acute Sinusitis?

Your sinuses are hollow spaces within the facial bones. Sinusitis is when these spaces become inflamed. Acute sinusitis is a common issue following a common cold or influenza. Often, it occurs when a person has already had a head cold/flu for 5 or 6 days, when the typical symptoms start to develop. In the majority of cases, it is caused by a viral infection, and therefore antibiotics are not helpful.

What are the symptoms of acute sinusitis?

The most common symptoms of acute sinusitis are:

• facial pain or pressure that feels worse when you lean forward/bend over.
• congested or stuffy nose
• nasal discharge which may be yellow/green

Other symptoms include:

• A sense of pressure in the ears
• Headache
• Impaired sense of smell
• An ache in your teeth
• Cough
• Halitosis (bad breath)
• Fatigue
• Fever

What is chronic sinusitis?

Sinusitis that lasts longer than 12 weeks is said to be “chronic”.

Does acute sinusitis get better by itself?

Yes, in most cases, acute sinusitis gets better after a few weeks, with simple, supportive treatment, such as rest, fluids and over-the-counter nasal sprays/painkillers, However, in some cases, if it is getting worse or not settling in the expected timeframe, a doctor may consider prescribed treatments.

When should I see a doctor about acute sinusitis?

Whilst most people with sinusitis do not need to see a doctor, you should seek medical attention if  symptoms are lasting longer than expected or are progressively getting worse You should see a doctor as soon as possible if you have a persistent fever (high temperature), or if you have a history of recurring bouts of sinusitis that tend to require treatment. Other signs of serious infection that require urgent medical attention include:

• severe pain/ severe headache
• noticeable redness and swelling around your eye(s).
• problems with your vision (such as double vision/blurred vision)
• High fever
• Dizziness
• Confusion
• Stiff neck
• A recent dental procedure

How is acute sinusitis diagnosed?

In the vast majority of cases, sinusitis can be diagnosed based on the history of symptoms.

Sometimes a doctor may recommend a scan/imaging if symptoms are continuing for months. If you have ongoing or frequently recurring symptoms, you may be referred to an Ear Nose and Throat specialist who may wish to perform a camera test (nasal endoscopy), to take a closer look at your nasal passages and sinuses. A nasal swab to test for certain infections, or tests to check for allergies may also be occasionally considered in such cases.

What are the risk factors or triggers for getting acute sinusitis?

As mentioned above, acute sinusitis most commonly arises at the end of a common cold or flu like illness.

However, other factors that can increase the likelihood of getting sinusitis include:

• hay fever
• smoking or passive smoking
• physical abnormalities in the nose/sinuses that affect drainage- e.g. a deviated septum or polyps.
• a compromised immune system
• a medical condition such as Cystic Fibrosis

What are the complications of sinusitis?

In some cases, a bout of sinusitis can continue for more than 3 months- this is known as chronic sinusitis and can lead to ongoing symptoms. Some people who suffer from chronic sinusitis continue to have mild symptoms on an ongoing basis, with flare ups of acute sinusitis from time to time.

Serious complications of acute sinusitis are rare, but can include meningitis, cellulitis (skin/soft tissue infection), and spread of bacterial infection to other parts of the body.

Can you prevent acute sinusitis?

It is not necessarily possible to entirely avoid getting sinusitis, but some strategies that may help include:

• avoid smoking/smoke exposure/air pollution exposure
• proactively manage any hayfever or dust allergies with appropriate treatment- get advice from your doctor or pharmacist if you are unsure.
• avoid exposure to respiratory viruses, stay away from people who are known to be unwell with common colds/flus.
• some people find using an air humidifier in their living space can help, particularly if their home heating/air conditioning system causes the air to be very dry. Humidifiers need to be properly cleaned/ maintained, to avoid mold developing.

What is the best treatment for acute sinusitis?

In most cases, sinusitis gets better by itself, after a few days/weeks. Supportive treatment can include:

• saline nasal sprays
• decongestant sprays (for a limited period of time- always read the label! Overuse can lead to “rebound” or worsening symptoms.)
• anti allergy nasal sprays (which may contain corticosteroids and/or an antihistamine)
• simple over the counter analgesia (painkillers) from the pharmacy
• antihistamine medications (if allergies are contributing to your symptoms)

Antibiotics are sometimes prescribed where it appears there may be a bacterial infection in the sinuses that is not getting better by itself.