What Are the Symptoms of Sinusitis?
Common symptoms of sinusitis include:
- Postnasal drip
- Discolored nasal discharge (greenish in color)
- Nasal stuffiness or congestion
- Tenderness of the face (particularly under the eyes or at the bridge of the nose)
- Frontal headaches
- Pain in the teeth
- Bad breath
Sinus disease is often confused with rhinitis, a medical term used to describe the symptoms that accompany nasal inflammation and irritation. Rhinitis only involves the nasal passages. It could be caused by a cold or allergies.
Allergies can play an important role in chronic (long-lasting) or seasonal rhinitis episodes. Nasal and sinus passages become swollen, congested, and inflamed in an attempt to flush out offending inhaled particles that trigger allergies. Pollen are seasonal allergens. Molds, dust mites and pet dander can cause symptoms year-round.
Asthma also has been linked to chronic sinus disease. Some people with a chronic nasal inflammation and irritation and/or asthma can develop a type of chronic sinus disease that is not caused by infection. Appropriate treatment of sinus disease often improves asthma symptoms.
How is sinusitis diagnosed?
Diagnosis depends on symptoms and requires an examination of the throat, nose and sinuses. Your doctor will look for:
- Swelling of the nasal tissues
- Tenderness of the face
- Discolored (greenish) nasal discharge
- Bad Breath
If sinus disease lasts longer than eight weeks, or if standard antibiotic treatment is not working, a sinus CT scan may help your doctor diagnose the problem. An allergist or an otolaryngologist (a doctor specializing in the ear, nose and throat) may examine your nose or sinus openings. The exam uses a long, thin, flexible tube with a tiny camera and a light at one end that is inserted through the nose. It is not painful. Your doctor may give you a light anesthetic nasal spray to make you more comfortable.
Mucus cultures: If your sinus disease is chronic or has not improved after several rounds of antibiotics, a mucus culture may help to determine what is causing the infection. Most mucus samples are taken from the nose. However, it is sometimes necessary to get mucus (or pus) directly from the sinuses.
Knowing what kind of bacteria is causing the infection can lead to more effective antibiotic therapy. A fungus could also cause your sinus disease. Confirming the presence of fungus is important. Fungal sinusitis needs to be treated with antifungal agents, rather than antibiotics. In addition, some forms of fungal sinus disease—allergic fungal sinusitis, for example—do not respond to antifungal agents and often require the use of oral steroids.
Your doctor may consider ordering a sinus CT. This test can help to define the extent of the infection. Your doctor may also send you to a specialist in allergy and immunology. The specialist will check for underlying factors such as allergies, asthma, structural defects, or a weakness of the immune system.
Biopsies: A danger of more serious types of fungal sinus disease is that the fungus could penetrate into nearby bone. Only a bone biopsy can determine if this has happened. Biopsies involving sinus tissue are taken with flexible instruments inserted through the nose.
Biopsies of the sinus tissue are also used to test for immotile cilia syndrome, a rare disorder that can cause people to suffer from recurrent infections, including chronic sinusitis, bronchitis and pneumonia.