Sinusitis is inflammation of the sinuses, usually due to an allergy or infection.

• Some of the most common symptoms of sinusitis are pain, tenderness, nasal congestion, and headache.

• Diagnosis is based on symptoms, but sometimes a CT scan or other imaging tests are needed.

• Antibiotics can clear an underlying bacterial infection.

Sinusitis is one of the most common conditions. It can occur in one of four groups of sinuses: maxilla, ethmoid, frontal or sphenoid. It almost always develops in association with inflammation of the nasal cavities (rhinitis), with some doctors calling it rhinosinusitis. It can be acute (short term) or chronic (long term).

Acute sinusitis is sometimes caused by bacteria. The infection often develops after a sinus obstruction. This obstruction is usually related to a viral infection of the upper airways, such as the common cold. During a cold, the swollen mucous membranes in the nasal cavity tend to block the sinus openings. The air in the sinuses is absorbed into the bloodstream and the pressure in the sinus decreases, causing pain and discharge. These secretions are a culture medium for bacteria. White blood cells and additional fluid enter the sinuses to fight bacteria. This influx increases the pressure and further increases the pain.

Sinusitis is said to be chronic when it lasts more than 90 days. Doctors don't understand exactly what causes chronic sinusitis, but it involves factors that cause chronic inflammation.

In children, sinusitis is suspected when a purulent discharge from the nose persists for more than 10 days and is accompanied by extreme fatigue and coughing. Pain and discomfort in the face may be present. Fever is not common. Doctors see a purulent discharge when examining the nose. A CT scan can confirm the diagnosis, but due to concerns about radiation exposure, it is usually only done in children with chronic sinusitis that does not go away with antibiotic treatment or with signs of complications.

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