Sinusitis is an inflammation of the sinuses, which are the interconnected hollow spaces in the bones around the nose. They can become blocked and infected after a cold, allergic rhinitis, nasal polyps or a deviated septum. If you would like to learn more about sinusitis, please click here to read more.
Acute Sinusitis: Overview
Common causes of Sinusitis:
- Viral “cold”
- Bacterial infection
- Allergy induced mucosal inflammation
- Fungal infection
- Poor air quality – smoking, pollution
Sinus symptoms overlap with several problems such as colds, allergy, migraine, dental problems and TMJ dysfunction. This makes accurate diagnosis challenging and diagnosis criteria have been developed.
Chronic Sinusitis: Overview
Chronic Sinusitis: Treatment Overview
Chronic Sinusitis: Overview
Conventional Criteria for the Diagnosis of Sinusitis
Based on the Presence of at Least 2 Major or 1 Major and 2 Minor Symptoms
- Major Symptoms
- Purulent anterior nasal discharge
- Purulent or discolored posterior nasal discharge
- Nasal congestion or obstruction
- Facial congestion or fullness
- Facial pain or pressure
- Hyposmia or anosmia (decreased smell)
- Fever (for acute sinusitis only)
- Minor Symptoms
- Ear pain, pressure, or fullness
- Dental pain
- Fever (for subacute or chronic sinusitis)
Modified from Meltzer, E. O. and D. L. Hamilos (2011). “Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines.” Mayo Clinic proceedings. Mayo Clinic 86(5): 427-443.
- Onset with persistent symptoms or signs compatible with acute rhinosinusitis, lasting for 10 days without any evidence of clinical improvement.
- Onset with severe symptoms or signs of high fever and purulent nasal discharge or facial pain lasting for at least 3–4 consecutive days at the beginning of illness, or
- Onset with worsening symptoms or signs characterized by the new onset of fever, headache, or increase in nasal discharge following a typical viral upper respiratory infection (URI) that lasted 5–6 days and were initially improving (‘‘double sickening’’).
2007 RSTF diagnostic criteria for Chronic Rhinosinusitis
RSTF = Task Force on Rhinosinusitis.
Twelve or more weeks of 2 or more of the following symptoms
- Mucopurulent drainage (anterior, posterior, or both)
- Nasal obstruction (blockage)
- Facial pain-pressure-fullness
- Decreased sense of smell
- Purulent mucus or edema in the middle meatus
- Polyps in the nasal cavity, and/or
- Inflammation of the paranasal sinuses on imaging
- Complete history and physical examination to obtain accurate diagnosis
- Diagnostic testing if indicated:
- Nasal endoscopy
- Sinus CT Scan
- Culture of sinus drainage
Sinusitis Treatment Options We Provide:
- Conservative Treatment
- Most sinus infections will resolve without antibiotics
- Allergy treatment if indicated
- Endoscopic sinus surgery
- Generally indicated for intolerable sinusitis symptoms despite maximal medical therapy.
- Balloon Sinuplasty: In Office or in Operating Room
Sinus Surgery: Overview
Balloon Sinuplasty: Overview
If you have Sinusitis problems, please call 503-257-3204 or request a visit online with us.
American Academy of Otolaryngology−Head and Neck Surgery. One Prince St., Alexandria, VA 22314-3357, 1-703-836-4444. 2010 AAO-HNS/AAO-HNSF
Rosenfeld, R. M., D. Andes, et al. (2007). “Clinical practice guideline: adult sinusitis.” Otolaryngology–head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery 137(3 Suppl): S1-31.
Hsueh, W. D., D. B. Conley, et al. (2013). “Identifying clinical symptoms for improving the symptomatic diagnosis of chronic rhinosinusitis.” International Forum of Allergy & Rhinology 3(4): 307-314.