What Are the Symptoms of Sinusitis?
Sinusitis is a condition that affects the nasal passages and sinuses. To understand the condition and potential complications, it helps to have an understanding of the anatomy in question. The paranasal sinuses, or sinuses, are the air spaces that fill the cheeks, forehead and areas between the eyes. While the bones of the face may feel solid, they are actually hollow - and these hollow spaces are the sinus cavities.
When the linings of these cavities become irritated or inflamed, there are many common symptoms, including:
● Nasal obstruction or nasal congestion
● Thick and discolored drainage (mucus)
● Decreased ability to smell or taste
● Facial pressure, discomfort, or a feeling of fullness
Sinusitis also can cause less common symptoms, including:
● Headache
● Fatigue
● Bad breath
● Fever
● Tooth pain (especially in the upper teeth)
● Cough
● Ear pressure
Because many of these symptoms could indicate the presence of another condition, your otolaryngologist (ear, nose, and throat doctor) will take into consideration a number of factors when making a diagnosis, including the timing of the symptoms and your specific combination of symptoms. He or she may order additional tests that can help with a correct diagnosis of your problem.
Are Sinus Infections Serious?
Sinus infections are painful, uncomfortable and irritating to sufferers, especially ones that linger. However, what many people don’t realize is that the cause of the infection and the location of the infection could lead to serious consequences when left untreated.
The term "sinusitis" refers to the condition -- the inflammation of the sinus linings or nasal passages. However, this term refers to a condition that has many causes, which can be very different. These infections may be viral or bacterial in nature, and the only way to determine whether or not you have a viral infection (e.g., the common cold) or a bacterial infection is to swab the inside of the nose and culture it. While this is typically unnecessary, patients who experience severe or lingering infections should seek medical attention to determine the cause and treatment options.
Doctors typically advise contacting health care providers if the infection lasts for more than 10 days, because most viral infections clear themselves within that period with home remedies - liquids, rest and over the counter (OTC) medications to manage symptoms. If these remedies aren’t working or your infection lingers beyond this time frame, then your doctor likely will recommend a course of antibiotics.
Most often, antibiotics help manage symptoms and offer patients more comfort. However, they may be prescribed to ward off potentially serious complications that can arise when a bacterial sinus infection spreads to the eyes or brain. Most often, these complications affect the eyes, causing redness, swelling around the eyes and reduced vision. Complications may even lead to blindness, a condition called cavernous sinus thrombosis.
If you suffer from any of these symptoms, you should seek immediate medical attention so that you can receive a dose of IV antibiotics to speed healing and limit or prevent permanent damage. Patients may be admitted to the hospital to get a CT scan, which helps doctors determine whether fluid needs to be drained.
Rarely, untreated bacterial sinus infections that occur near the center of one’s head can spread into the brain, causing potentially life-threatening conditions like meningitis or a brain abscess.
What Else Could It Be?
Because sinusitis symptoms are somewhat vague or generic in nature, there are other conditions with symptoms that can mimic those of a sinus infection. Among these conditions:
Viral Upper Respiratory Infection (URI) or Common Cold: The common cold shares many of the same symptoms of sinusitis and may lead to sinusitis, but these conditions are treated differently.
Environmental Allergies: The symptoms of environmental allergies and sinusitis overlap somewhat, and allergies may trigger a sinus infection. Among the symptoms that both conditions share, patients may experience sneezing, clear nasal drainage (mucus), itchy nose or throat, itchy or watery eyes, and itchy skin. Allergy symptoms tend to fluctuate with seasonal changes and are worse during predictable periods in the year. They also tend to change depending on your environment, such as going from indoors to outdoors. Most people who suffer from allergies will be able to identify specific triggers for their symptoms, such as increased pollen count or contact with house pets, like cats or dogs.
Sinus Headaches: The term "sinus headache" is commonly used but can be misleading. Facial pain or pressure with a headache that occurs without nasal congestion or discolored drainage is only rarely associated with true sinusitis. There are many causes of headache that include facial pain, including migraine headaches, tension headaches and temporomandibular joint (also called TMJ or jaw joint), as well as dental issues and, rarely, tumors.
Acid Reflux: Acid reflux is a condition where stomach acid backs up and irritates the esophagus or throat. This condition can cause symptoms that are commonly associated with sinusitis, including thick phlegm in the throat, post-nasal drainage, chronic throat discomfort/clearing and intermittent voice changes. Because acid reflux needs different treatment and may cause permanent damage if left untreated, it’s important to seek a diagnosis from your doctor to determine whether this may be causing your discomfort.
What About Serious Conditions?
There are some serious conditions that may mimic the symptoms of a sinus infection, with additional symptoms that, if experienced in conjunction with a sinus headache, should encourage you to seek medical attention. Among them:
Temporal Arteritis
Giant cell arteritis, or temporal arteritis, is a condition that affects the temporal arteries, as well as the ophthalmic, occipital, vertebral, posterior ciliary and proximal vertebral arteries and may involve medium or large vessels, including the aorta and carotid arteries. In addition to common sinusitis symptoms, patients with temporal arteritis may experience visual disturbances, headache, jaw claudication, neck pain or scalp tenderness. Vision loss is one of the most common effects of this condition and may occur in up to 20 percent of patients. Early detection and treatment are essential to preventing vision loss or blindness.
Wegener's Granulomatosis
Wegener's granulomatosis is an extremely rare condition that affects about one in 25,000 people. This condition is an immunologic disease with an unknown cause, characterized by an inflammatory process that affects the blood vessels and other tissues in the body. Between 80 and 90 percent of patients with this disease develop symptoms that include nasal pain, nasal bleeding, bloody or dry mucus crusts, a foul odor from the nose, nasal obstruction, and sinus pain. They also suffer from symptoms such as severe headaches, migrating joint pain, weight loss, drenching night sweats, nosebleeds and breathing problems. Treatment for this disease involves immunosuppressive drugs to stop the inflammation of the vessels, which will help put patients into remission. The drugs can be tapered to a level that will maintain that remission and prevent further tissue damage.
Whether or not your symptoms are alarming -- or just uncomfortable – if you experience what you think is sinusitis, see your healthcare practitioner for a diagnosis and relief. There's no need to suffer from pesky and painful symptoms.