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How To Tell When It’s Sinusitis

A cold that hangs around for more than 10 days or seems to get worse before it gets better may not be a cold after all.

Cold-like symptoms that last this long or become this severe may be a sign that you have  sinusitis – a chronic condition that affects one in eight adults every year, according to the American Academy of Otolaryngology. Sinusitis, also known as a chronic sinus infection, is the inflammation of the sinus pathways caused by one of many viruses, of which the rhinovirus is the most common.

Knowing the Symptoms

Sinusitis may include a variety of symptoms, ranging from a loss of smell, nasal drainage, mid-face pain or pressure, and congestion. Understanding the symptoms of sinusitis can help you get the timely care you need to combat the illness, says Stewart Adam, MD, an ear, nose and throat (ENT)/head and neck surgical specialist.

“It can be very frustrating to deal with chronic sinusitis and recurrent acute sinusitis,” says Dr. Adam. “Frustration can stem from many things including the cost of having to take time off of work to a decrease in the quality of life. These costs take a toll at both the individual and family level and at a societal level. By the time many chronic sinus patients are able to come in and be evaluated by a specialist, the frustration and fatigue of dealing with this chronic condition is self-evident.”

Sinusitis most often begins when you develop a cold or upper respiratory illness or suffer from allergies. In each of these cases, your sinus pathways may become inflamed, blocking airflow through sinus cavities and keeping mucus from properly draining out of them. Static mucus can become infected, prolonging the issue for up to several weeks.

There are three types of sinusitis: acute sinusitis, sub-acute sinusitis, and chronic sinusitis. Each type of sinusitis is determined by how long it lasts. Acute sinusitis lasts up to four weeks, sub-acute lasts up to 12 weeks and chronic sinusitis can last anywhere from 12 weeks, to several months. Acute sinusitis can usually clear up without any medical intervention, but the longer symptoms last the more likely treatment needs to be considered.

Finding Relief

Dr. Adam says sinusitis is often treated with what is called maximum medical therapy, which is a combination of antibiotics, steroids, topical steroids, and nasal saline.

“Eighty percent of the time, this is all a patient will need to get relief from their symptoms,” Dr. Adam says. “If they continue to have symptoms despite these treatments then they will be referred to an ENT doctor where we can do additional imaging to determine if there is an undiagnosed cause.”

Patients who come to Dr. Adam often undergo one of two tests that provide a closer look into their sinus cavities. A fine-cut CAT scan, with thin, 1 mm image slices, and a scope can help determine if a patient might have an anatomic issue, such as a deviated septum, that contributes to their condition. The septum divides the two sides of the nose, and when slightly shifted to one side, can make infections develop. Patients may also have nasal polyps, which can obstruct passageways.

Both conditions can be treated to help open up your nasal cavities and allow for better air flow and drainage. This may involve surgical intervention. However, Dr. Adam says caring for symptoms when they first arise may keep you from developing sinusitis in the first place. He recommends the following steps:

• Keep the nasal passages clear. One of the best ways to keep your sino-nasal passages clear is to use a saline nasal spray. Spraying a saline solution into each nostril up to 6 times a day can help keep it clear and reduce the risk for inflammation.
• Treat allergy symptoms. Allergies can predispose you to sinus infections. Treating allergy symptoms can reduce the risk for developing an infection. Antihistamines, such as those found in oral allergy medications, can help keep allergies in check.
• Grab a decongestant. Medications such as Sudafed are systemic decongestants that help decrease inflammation that leads to infection. These medications may have side effects, so consult your doctor before using.
• Consider a nasal steroid. Topical nasal steroids such as over-the-counter Flonase can be used daily for up to a month to provide relief. Be mindful that it may take up to five days before seeing relief from symptoms. Do not use for more days than instructed.

Source: Stewart Adam, MD, Premier ENT Associates; American Academy of Otolaryngology