DESCRIPTION: A bacterial or viral infection of the moist membrane that lines the air filled sinuses in the face. They lie in the skull bone below, above, between and behind the eyes and are connected together and to the nose by small holes and drainage tubes.
CAUSE: Some people secrete excess amounts of fluid in the sinuses because of hay fever, smoking or irritating fumes, while others may have drainage holes and tubes that are too small to cope with the secretions produced. If bacteria or viruses infect the sinus lining or secretions, sinusitis results.
SYMPTOMS: Thick and pus-like phlegm drains from the nose and down the throat, the face is very painful and tender, and there is a fever, headache and tiredness.
INVESTIGATIONS: X-rays of the sinuses shows the abnormal presence of fluid. Swabs may be taken from the back of the nose so that the type of bacteria causing the infection can be determined and the correct treatment selected.
TREATMENT: Appropriate antibiotics when the cause is bacterial, and other medications to dry phlegm and clear the sinuses. Inhalations of steam and nasal decongestant drops are beneficial. In patients who suffer from repeated attacks, surgical procedures to more effectively drain the sinuses can be performed.
COMPLICATIONS: Infection may spread to the middle ear, and in severe cases, it may be necessary to insert needles through the nose into the sinuses to wash out the pus. Untreated the infection can spread to the teeth, eyes or brain, and abscesses may form.
PROGNOSIS: Most settle quickly with appropriate treatment, but recurrences common.