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Almost everyone has had a bad head cold at one time or another. If yours seemed to hang on and on, it may have been sinusitis. Sinusitis is an infection of the tissue lining the sinus cavities of the head. Symptoms of sinusitis vary greatly. Most adults experience sinus headaches or tenderness over the sinus areas (forehead and cheeks) that may worsen with a change in position. You may even experience pain over your upper teeth, fever, a decreased sense of smell, sore throat or bad breath.

Children’s Symptoms May Not Be Obvious

Adult sufferers usually have congestion and a discharge or post nasal drainage. Symptoms in children may not be as obvious. Nasal congestion and coughing that worsen after lying down at night are indications. Ear infections are common.

Infections

There are four groups of sinuses, and any one or all of them may be infected. Some of the sinuses are present at birth while others do not develop until adolescence. Infection can occur when the sinus opening is obstructed. Blockage may result from many different factors, including the common cold, inhalant allergies, enlarged adenoids, deviated nasal septum or a foreign body in the nose. Simple trauma, even the effects of swimming or diving, may obstruct the passage.

Diagnosis and Treatment

The diagnosis of sinusitis can be con firmed by x­rays of the sinuses. A sample of the mucus of the nose may be helpful to explain the underlying cause.

A culture of the sinus is often difficult. Antibiotic therapy is usually directed against the bacteria already known to cause such problems. Usually a three-week course of antibiotic therapy is required for most infections. At times, one course is not sufficient and additional three-week courses may be necessary. Other medications may also be prescribed to control contributing factors.

Antihistamines can be valuable if allergies are part of the picture. A decongestant may be prescribed to help promote drainage detoxic. Nasal decongestant sprays must be used with caution since prolonged or excessive use may actually worsen congestion. Often nasal sprays that act like cortisone may be of benefit. Steam mist or washing the sinuses can be helpful. Cough suppressants may be necessary early in treatment.

After treatment, additional x­rays may be required to assure the infection has been treated adequately. At times, special x­rays, such as a CT scan, are needed when the infection fails to improve after treatment.

Controlling Sinusitis

Controlling the environment is essential for proper recovery. Tobacco smoke must be avoided because it harms the cells of the nose that help filter particles and bacteria in the air. Avoid allergens such as ani mal dander or dust. Controlling air temperature and humidity may also help speed recovery.

If sinus infections persist or continue to recur, the contributing factors should be identified. Your physician should take a careful history and physical examination. Allergy skin testing by a board­certified allergist/immunologist may be necessary to determine if allergies contribute to the illness. A weakened resistance to infection may also lead to recurrent sinus infections and other tests may be required.

Surgery

In some instances, medications alone are not sufficient to prevent the recurrence of sinusitis. An otolaryngologist may then recommend surgery to correct the abnormality causing the sinus obstruction. Many new techniques are now used to make the surgery easier and safer.

Complications of sinusitis are rare today due to the use of antibiotics. However, patients with asthma may worsen significantly when they develop a sinus infection.

Sinusitis is such a common condition it results in millions of days lost from work or school each year. Early recognition and management of sinus infections are essential to help us avoid this troublesome condition, and to let us get back on our feet faster when an infection does occur.

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