What is it?
There are 4 pairs of sinuses connected to the nasal cavity by small openings called ostia. Nasal sinuses are small mucous-lined pockets within the facial bones surrounding the nose. Normally, these sinuses make mucus that drains from the sinuses into the nose while air passes freely in and out.

Sinusitis is a disorder of the sinuses surrounding the nose, where one or more of these sinuses are inflamed. Acute sinusitis typically lasts 3 to 8 weeks, whereas chronic sinusitis lasts longer.

What Happens?
The classic symptoms of acute sinusitis are nasal congestion, greenish nasal phlegm (discharge), facial and/or dental pain, eye pain, headache, and a nighttime cough. Some patients also complain of fever, malaise (feeling ill), bad breath, and a sore throat. It is usually preceeded by a URI (cold), which does not improve or worsens after 5-7 days of symptoms.

Chronic sinusitis is subtler, and can be difficult to diagnose. It manifests the symptoms listed above in a milder form, but usually persists for longer than 8 weeks. It is most common in patients with allergies.

Why Does it Happen?
Sinusitis (inflammation of the sinuses) occurs when at least one of three conditions is manifest: (1) The small openings (ostia) from the sinuses to the nose are blocked; (2) small hairs (cilia) in the sinuses that help move the normally produced mucous out are not working; and (3) too much mucous is produced, often simply a result of inflammation. Any combination of these may cause sinusitis.

Sinusitis typically follows an upper respiratory infection or allergic reaction, which can cause inflammation and swelling that closes off the sinus ostia. This encourages mucous accumulation in the sinuses, and makes the sinus a great place for bacteria and fungus to live and grow rapidly. Individuals with weakened immune systems are at greatest risk, since their risk of any infection is high.

Other risk factors include: history of asthma; overuse of nasal decongestants; deviated nasal septum; nasal bone spurs; nasal or facial tumors; nasal polyps; foreign bodies; frequent swimming and/or diving; and dental work. Typically, these all cause blockages of the sinus ostia, and are the result of problems that affect the nasal area only.

Can I stop It?

• Appropriately treat allergies and upper respiratory tract infections, and avoid cigarette smoke and adverse environmental exposure (pollution).
• Avoid temperature extremes because sudden changes in temperature will increase sinus pain. Avoid bending with the head down because this usually increases the pain.
• Because moisture thins mucus and allows it to drain better, use a humidifier or steam to increase moisture in the nose and sinus area. Drink plenty of fluids to increase moisture within your body. Use of decongestants during upper respiratory infections may reduce the chances of developing sinusitis.

Treatment 
The goals of treatment are twofold: the relief of the symptoms and the cure of the infection. Symptoms can be relieved with a saline spray, a lavage, or with a humidifier. While nasal decongestants can also be helpful, the use of topical (spray) nasal decongestants beyond 3 to 5 days can actually worsen nasal congestion. Steroids may also be used to help decrease the swelling, especially in patients with swollen structures, such as nasal polyps, or allergies.

Antibiotic treatment aims at curing the disease. Common antibiotics include: Ampicillin, Amoxacillin, Bactrim (Trimethoprim with Sulfamethoxazole), Augmentin, Cefuroxime, or Cefprozil.