Sinusitis: Sniffling snags

If not treated properly, acute sinusitis may eventually develop into chronic sinusitis, needing surgery


Sinusitis, in simple terms, means an infection of the sinuses. The condition can be of two types, depending on the duration of symptoms:

  • Acute: Up to four weeks
  • Chronic: More than eight weeks [sometimes, several months, or even years].

What are sinuses

Sinuses are hollow air-filled cavities in the bones of the face, situated around the nose. Each sinus has an opening in the nose that helps in the ventilation and drainage of mucous. The sinuses also have a lining that is linked with the nose. There are tiny hair-like cells in this lining that move to and fro to drain out the mucous.

There are four sinuses:

  • Above the eyes [forehead]
  • On either side of the nose [cheek]
  • Behind the bridge of the nose; in-between the eyes
  • Above and behind the nose.

Acute sinusitis

Anything that causes swelling of the sinus lining, or prevents the hair like cells from moving the mucous, can cause sinusitis. Acute sinusitis mostly starts as common cold—usually caused by a virus. This further develops into a sinus infection, as the lining of the sinus swells, providing the perfect soil for the multiplication of bacteria. Allergy, irritation from pollutants, changes in temperature or air pressure, excessive usage of nasal decongestant drops/sprays, and smoking, predispose acute sinusitis.

Chronic sinusitis

Some experts think that chronic sinusitis is an infectious disease, while others debate about it being an allergy. Individuals with asthma or allergies—including air-borne allergens like house-dust mites, mould or pollen—are prone to chronic sinusitis. People who have had acute sinusitis and are not properly treated with antibiotics or other therapies may eventually develop chronic sinusitis.

Infection from the throat, upper jaw, and trauma to the sinuses can also cause chronic sinusitis. Poor living conditions, obstruction to sinuses due to deviation of the nasal septum, allergies, small growths [polyps] and asthma, are other predisposing factors.


  • Aching, redness and swelling of the cheek spreading to the lower eyelid
  • Swelling of the upper eyelid
  • Marked swelling of the eyelids and area above and towards the root of the nose
  • Fever
  • Nose block
  • Runny nose
  • Aching in upper jaw and teeth
  • Pain over the forehead, when you wake up in the morning; this gets aggravated when you bend
  • Pain on the bridge of nose, between the eyes, which is increased by eye movements
  • Pain at the top of the head, earache, and pain in the neck.


Acute sinusitis is treated with  antibiotics, decongestant tablets and nose drops [to reduce the swelling of the nasal lining and sinus openings], anti-inflammatory and pain-killer tablets, and steam inhalation [10 minutes after instilling nose drops, 2 – 3 times a day; the ventilation of the sinuses improves after nasal decongestion]. Most patients of acute sinusitis respond well to medical therapy and rarely require surgery.

When medical treatment fails, or if your CT scan reveals extensive chronic sinusitis, surgery may be necessary.

Preventive Measures

There are certain precautions you can take to reduce the frequency and severity of sinus attacks and probably prevent acute sinusitis from becoming chronic.

  • Alcohol: causes the lining of nose and sinuses to swell
  • Swimming: Chlorinated water causes irritation of the nasal and sinus lining
  • Diving: causes forceful entry of water into the sinuses through the nose
  • Smoking: Nicotine irritates and also affects the movement of the cilia in the sinus lining
  • Air travel: Use a nasal decongestant spray before take-off to avoid pressure build-up and blockage of sinuses.

Handy tips during sinusitis

  • Take rest. At times lying down can increase the heaviness in the sinuses, leading to headache and nasal blockage. Rest in propped up position, or lie on the sides
  • Drink plenty of liquids, especially warm fluids [e.g., soups]
  • Steam inhalation: 2 – 3 times/day
  • Rinse the nasal cavity with saline solution. This helps in removing the thick sinus discharge.

This was first published in the December 2013 issue of Complete Wellbeing.

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Ravikiran Vernekar
Dr Ravikiran M Vernekar is a full-time consultant in the department of ENT and Head & Neck surgery at Dr L H Hiranandani Hospital, Mumbai. He has a high success rate in treating patients with headache, especially sinus headache and allergic conditions of nose.



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