Sinusitis Symptoms, Risk Factors, Diagnosis and Treatment | Narayana Health

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Symptoms, Causes, Risk Factors, Diagnosis & Treatment



What is Sinusitis?

Sinuses are air pockets that are present behind the nose, cheekbones, between the eyes and forehead. The lining of these sinuses are responsible for producing mucus, the slimy fluid that protects against foreign particles and germs from entering the body via the nasal cavity by trapping them. Inflammation of this lining can cause mucus to build-up excessively in the nasal passages which can lead to blockages, leading to bacterial and viral infection, this condition is called sinusitis. Sinusitis affects an estimated 134 Million Indians, severe and chronic Sinusitis can be debilitating and hamper the patients' quality of life.



Symptoms of Sinusitis

Sinus Treatment

Symptoms of Sinusitis are often indistinguishable from a common cold. If symptoms do not improve in 1-2 weeks it is necessary to consult a doctor to ensure that the infection is not aggravated.

The symptoms to watch out for are:

  • Runny nose or blocked nose
  • Severe headaches / facial pain
  • High fever
  • Constant and persistent cough
  • Decreased sense of smell



Types of Sinusitis

Acute Sinusitis

When viral infection caused by the common cold leads to inflammation of the nasal passage it is called acute sinusitis. The symptoms usually last around two weeks and up to four weeks. This kind of Sinusitis can also be caused by seasonal allergies such as pollen or dust.

Subacute Sinusitis

When a Sinus infection lasts for more than 4 weeks and up to 3 months it’s called subacute sinusitis. It is recommended to meet a professional if the sinus infection lasts for more than a week.

Chronic Sinusitis

When Sinus infection lasts longer than 3 months it’s called chronic sinusitis, this is mostly the case when patients have structural nasal problems or persistent allergies.



Causes of Sinusitis

The common conditions that cause Sinus infection include:

The common cold: If a cold is not treated at the appropriate time, it may aggravte into a sinus infection.

Allergic Rhinitis: Also known as hay fever, this is an inflammation of the nose that occurs due to a heightened sensitivity to allergens. The symptoms include a constant running nose, itchy eyelids and watery eyes.

Nasal Polyps: These are soft painless growths in the inner lining of the nose, they are benign and non cancerous, however they could cause obstruction to drainage and lead to development of Sinus Infections.

Deviated Septum: This occurs when your nasal septum, the thin wall between your nasal passages has eviated (bent) to one side. It can be form birth or due to any injury to the nose.



Risk factors

Certain health conditions or risk factors can increase the chances of developing a sinus infection such as:

  • A deviated septum.
  • Nasal Polyps
  • Severe allergies leading to inflammation
  • Exposure to mold (fungus)
  • History of smoking
  • Infection of teeth
  • Cystic Fibrosis (Build-up of mucus in lungs)
  • Respiratory tract infections such as Bronchitis
  • Generally a weak immune system



Steps to prevent Sinus infection

  • Maintain strict hygiene and avoid contact with those suffering from Cold and Flu to prevent contracting respiratory tract infection
  • Vaccination against preventable infections such as influenza
  • Diet rich in antioxidants (Fresh fruits - like Plums, Cranberry, Grape, Peaches)
  • Reduce daily stress
  • Plan and prevent exposure to seasonal allergens such as pollen by wearing face masks
  • Staying hydrated at all times to keep nasal secretions thinso the draingae is not blocked
  • Steaminhalation/ Taking a hot shower to keep nasal passages moist
  • Avoid smoking and passive smoking



Sinusitis and headaches

Sinus Headaches

A Sinus headache is caused when there is a blockage and the sinuses are not drained adequately. The mucus build-up in the sinuses can lead to increased pressure sensation and pain.

Only Acute Sinus infection leads to headaches and facial pain. Generally chronic sinusitis is not associated with headache and other causes of headache such as migraine and facial pain should be investigated for. More than 80% of people with sinus headaches actually have migraines.




The first step for your doctor will be to inquire about your symptoms and your medical history. They may examine the inside of your nose to check for blockages and look for other causes and risk factors of Sinusitis.

In the case of chronic sinusitis, your doctor may recommend further tests such as a CT scan. This is done to reveal if there are any abnormalities such as a deviated septum or the development of nasal polyps which may require surgical treatment.

They may also choose to conduct a nasal endoscopy, where a camera attached to a fiber optic scope is passed through the nose. The doctor may also obtain a sample of mucus for culture testing to check for the presence of bacterial infection.



Treatment of Sinusitis

Sinus Headaches

Sinus is treated based on the underlying cause of the infection and based on the seriousness of the infection your doctor may prescribe the following courses of action.

Home remedies:

Use a humidifier - This can help to ensure that the air around you is moist and relieve nasal blockage that develops overnight.

Steam inhalation - You can also inhale steam or use a hot shower for relief. For steaming fill up a bowl with hot water and lean over it while covering yourself in a blanket to prevent steam from escaping. Initially inhale through both nostrils and then alternate between nostrils to ensure the passages are completely clear. Cough up the loose phlegm and blow your nose to get rid of the mucous causing blockage.

Essential oils - Oils like eucalyptus oil/menthol etc can provide relief as well. However they must be used with caution for only short periods of time as there is evidence that they can cause epilepsy

Jala Neti (Irrigation of nose)/saline nasal douching - Irrigating the nose using saline water is an effective home remedy for Sinusitis. Make sure to use purified water in the case of nasal irrigation to prevent the risk of contaminants.

Use a warm compress - Another go to method to clear up the nasal passages is the use of a warm towel. Placing the towel over the affected area while resting or sleeping can help loosen up the passages and provide relief.

Rest adequately - Sinusitis can be very taxing on the body especially if over a prolonged period of time. Make sure you get plenty of rest to give yourself a good chance to recover.

Nasal decongestant sprays:

These medications are used to clear up the nasal passages and make it easier for mucus to drain out from the sinuses. But use caution and only use them for a short period of time (usually 5-7 days)


If Sinus infection is caused by bacterial infection, only then a course of antibiotics can improve the condition. However, if antibiotics are used indiscriminately they can lead to antibiotic resistance. Hence antibiotics should be used sparingly and only after consulting with the doctor.


If Sinus infection is caused due to seasonal allergies then using an antihistamine can resolve the problem. The Antihistamine reduces inflammation caused due to the allergen and prevents the onset of infection. Otherwise the antihistamines can dry the secretions and hamper with adequate drainage of the blocked sinuses.

Pain Remedies: Medications such as paracetamol and ibuprofen can help alleviate symptoms such as fever,headache and facial / body pain.


In the case of structural deformities such as a deviated septum or nasal polyps there might be a need forsurgical treatment.

Types of Sinus surgery:

Functional endoscopic sinus surgery

In this form of surgery, an endoscope is inserted into the nasal passageway. The doctors then use special surgical instruments to remove any kind of blockages such as nasal polyps. The procedure does not leave behind any trace of scarring. If the sinusitis reoccurs, the surgery can be repeated a few times.

Caldwell-Luc operation

This is more or less an obsolete procedure and may be done in some very specific cases. In this procedure, the surgeon creates a pathway between nose and the maxillary sinus to aid in the easy drainage of any mucus that builds up in the area. The surgery is performed by making a cut in the premolar region of the upper jaw to enter the sinus cavity. The procedure is only recommended if there is a growth inside the sinus cavity that needs to be removed.



Road to recovery and aftercare

The recovery after sinus surgery is usually quick as it is an endoscopic procedure. The doctor might insert a sterile gauze/pack into the nasal cavity to prevent any kind of bleeding after the surgical procedure. In most cases the gauze/pack that is used is dissolvable and is absorbed by the body. In case a non-dissolvable gauze is used, the doctor usually removes it in a separate procedure in a day or two after the surgery

The patients may experience nasal congestion, slight bleeding and fatigue as a result of surgery for a few days upto a few weeks after the surgery. The doctor may recommend a course of antibiotics and may also recommend painkillers and saline rinse to ensure the blockages are completely cleared and disinfected.



Risks or complications

It’s important to consider the risks involved while undertaking any surgery. Make sure to consult with the doctor to understand all the possible risks before going ahead with your decision. Here are the possible risks and complications of Sinus surgery.

Eyesight impairment

Sinus surgery can in rare circumstances lead to damaged eyesight or blindness during the procedure. This happens if the layer of bone between the eye and the nose is damaged and the eye gets injured. In rare cases, the tear ducts of the eyes can be affected leading to involuntary tearing up. There may also be cases where the muscular structure of the eye is affected leading to double vision and deterioration of eyesight.


In rare cases, the bone between the nose and the brain may be damaged during surgery and brain fluid can leak into the nasal passages. This can lead to an infection of the brain membrane called meningitis, which can potentially be fatal.

Smell or taste impairment

After the surgery, there may be complications where infection affects the sense of smell or taste for a short period of time. These usually resolve a few days after the procedure.

Blocked airflow

Sinus surgery is usually successful in improving airflow through the nasal passages, however, in rare cases, there may a build-up of scar tissue in the nose that leads to blockage. This will require corrective surgery at a later stage.


As with every surgery, there is a risk of bleeding after the procedure. This is usually prevented by using nasal packaging, but in case of a blood clot or excessive bleeding, there may be a need for revision surgery to remove the clot or stop bleeding.



Sinusitis FAQs: All your concerns addressed

Q.  How long can Sinus Infections last?

  1. Depending on the kind of infection it last anywhere between a week and upto three months or longer. If it lasts longer than three months, it’s called chronic sinusitis and may be a result of structural deformities.

Q.  What’s the fastest way to get rid of a sinus infection?

  1. Stay hydrated and drink fluids to thin out the mucus.
    Eat foods rich in antioxidants.

Q.  How do I drain my sinuses naturally?

  1. Apply pressure between your eyebrows on the forehead and push your tongue against the top of your palate. The pressure that’s created will lead to your sinuses draining out naturally – Really? Where did you find this ?

    Warm your hands by rubbing them together. Place your fingers around your forehead above the eyebrows and apply pressure. In a circular motion, massage your temples and apply pressure.
    Repeat the motion for close to 30 seconds.

Q.  How long does Sinus surgery take?

  1. Sinus surgery can take anywhere between two to four hours. It can be done as a day case surgery and usually doesn’t need an overnight stay.

Q.  How is Sinus surgery done?

  1. In Sinus surgery a nasal endoscope is used to perform the procedure, there is no need for any external incisions and it is performed under general anaesthesia.

Q.  Do Antihistamines help sinus infection?

  1. If the cause of your sinus infection is seasonal allergies such as exposure to pollen, mites, dust, pet hair and the likes, antihistamines may help the problem. However, the constant use of antihistamines can lead to drying up of the sinuses and slow down the draining process. It is not advisable to take histamines without a doctor prescription. Consult with a doctor to diagnose if your sinus infection is being caused by exposure to allergens, your doctor may conduct a patch test or other diagnosis to determine the root cause and recommend the best course of action.

Q.  Can Sinus infection cause fatigue?

  1. Similar to any infection, the body spends energy fighting the Infection. Since there is a constant mucus production, sufferers may constantly blow their nose in an effort to clear their nose. There may also be prolonged headache and discomfort due to a blocked nose during this time leading to the feeling of fatigue.

Q.  How should I alter my diet during Sinus infection?

  1. If you suffer from a sinus infection, you must avoid foods that cause inflammation in the body. It also helps to keep drinking plenty of fluids to ensure that the mucus is easily drained from the body.

The foods to avoid include:

  • Sugars: Avoid desserts, chocolate bars, processed foods, juices and sodas as they have high sugar content.
  • Saturated fats: Junk food such as Pizza, Pasta, Cheese must be avoided as they can trigger fat tissue inflammation.
  • MSG: Canned foods that have a high monosodium glutamate content must be avoided.
  • Refined Carbohydrates: Mashed potatoes, cereals, white bread, dough must be avoided as they have a high glycemic index and cause inflammation.

Foods to include:

To reduce inflammation it is recommended to have diet that is rich in antioxidants and Omega 3 fatty acids.

  • Add fish such as sardines and cod to your diet that are rich in healthy fats.
  • Turmeric which has curcumin can help reduce inflammation in the body.
  • Red bell peppers which are rich in Vitamin C.
  • Leafy vegetables such as asparagus and broccoli.
  • Oranges, grapefruits, berries that are rich in Vitamin C.
  • Green tea can help the body stay hydrated.
  • Cayenne pepper to help in thinning of the mucus and clear out the sinuses.

Q.  Can Sinus infection cause fatigue?

  1. Similar to any infection, the body spends energy fighting the Infection. Since there is a constant mucus production, sufferers may constantly blow their nose in an effort to clear their nose. There may also be prolonged headache and discomfort due to a blocked nose during this time leading to the feeling of fatigue.

Q.  What does sinusitis look like?

  1. There are several signs and symptoms which can help you determine if you have sinusitis or not. If you have sinusitis, then it may include the following symptoms:
    • Headache
    • Facial swelling
    • Painful sensations
    • Congestion
    • Postnasal drip
    • Cough
    • Sore throat
    • Pain in eyes, ears, and teeth
    • Foul breath
    • Exhaustion
    • Itching or sneezing

Q.  Is it possible to live with chronic sinusitis?

  1. Some people experience short term symptoms of sinusitis such as postnasal drip, nasal mucous, and congestion. However, there are patients who experience chronic sinusitis, have more systemic symptoms. They also face some amounts of depression, anxiety, productivity loss, and problems with concentration. Medical and surgical management is the way out in these cases and patients have shown positive results after going through endoscopic sinus surgery. A majority of these patients can be treated on an outpatient basis. Even after the surgery, the treatment needs to continue postoperatively to ensure that the causes of the sinus are resolved.

Q.  Can I have sinus without a nasal discharge?

  1. Almost always, sinus headaches occur with congestion. Nasal discharge is one of the most common symptoms of sinus. This happens due to the fact that the swelling and mucus block the sinuses and cause pressure to build up, thereby preventing proper airflow or drainage of the mucus. Since it’s rare to get a sinus headache without nasal congestion, it’s important to diagnose it with a doctor whether it’s a sinus headache or not.

Q.  What causes sinusitis?

  1. Some of the common causes of sinusitis are:
    • Nasal polyps - These are tissue growths that can obstruct the nasal passages or sinuses
    • Deviated nasal septum - If the septum, or the partition between the nostrils, is crooked, then it can restrict the passage of sinus, leading to sinusitis symptoms.
    • Respiratory tract infections - In case there is an infection in your respiratory tracts, it can thicken your sinus membranes and restrict any sinus drainage.
    • Allergies such as hay fever - Any inflammation that comes along with allergies can also block sinuses.
    • Other medical conditions - There can be other complications such as cystic fibrosis, HIV, and other immune system-related disorders which can also lead to blockage of the sinus.

Q.  What best treatment can I expect for sinusitis?

  1. There are several treatment options you can choose from, depending on the exact problem. The different methodologies for chronic sinusitis are:
    • Nasal corticosteroids - It’s a kind of nasal spray that can help prevent and treat inflammation. For example - fluticasone, triamcinolone, and beclomethasone.
    • Saline nasal irrigation - This can be done with nasal sprays and solutions and helps reduce drainage, as well as rinse away irritants and allergies.
    • Oral or injected corticosteroids - In case you have severe sinusitis, you can use these to reduce the swelling, especially if you have nasal polyps.
    • Aspirin desensitization treatment - In case the sinusitis is a result of allergies to aspirin intake, then you’re given larger doses to increase your tolerance.

Q.  How can I get tested for sinusitis?

  1. You can visit your doctor to get tested for sinusitis. The doctor can check for any tenderness in your nose and face. The doctor may also recommend some tests such as imaging tests like MRI and CT scan, checking the sinus by inserting a tube with fiber-optic light through your nose, allergy test, or collecting nasal or sinus samples.

Q.  What will happen if my sinusitis remains untreated?

  1. In case you don’t get your sinus treated, then you might feel some pain and discomfort till the sinus clears up. In extreme cases, your sinus can also lead to meningitis, brain abscesses, or bone infections. You should visit a doctor in case of any such thing.

Q.  Are there any natural home treatments for sinusitis?

  1. You can try some natural alternatives or over-the-counter medications for your sinus problems:
    • Saline nasal spray
    • Neti pot
    • Acupressure
    • Steam inhalation
    • Hydralation
    • Essential oils



Outlook and Prognosis

Sinus infections usually last for two weeks and go away on their own. OTC medications and home remedies can help relieve the symptoms. If the symptoms last longer than two weeks it’s recommended to meet a doctor.