The sinuses are air-filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes. Healthy sinuses contain no bacteria or other germs. Most of the time, mucus is able to drain out and air is able to flow through the sinuses.
The health care provider will examine you or your child for sinusitis by:
Looking in the nose for signs of polyps
Shining a light against the sinus (transillumination) for signs of inflammation
Tapping over a sinus area to find infection
The provider may view the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) to diagnose sinusitis. This is often done by doctors who specialize in ear, nose, and throat problems (ENTs).
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
Apply a warm, moist washcloth to your face several times a day.
Drink plenty of fluids to thin the mucus.
Inhale steam 2 to 4 times per day (for example, while sitting in the bathroom with the shower running).
Spray with nasal saline several times per day.
Use a humidifier.
Use a Neti pot or saline squeeze bottle to flush the sinuses.
Be careful with use of over-the-counter spray nasal decongestants such as oxymetazoline (Afrin) or neosynephrine. They may help at first, but using them for more than 3 to 5 days can make nasal stuffiness worse and lead to dependence.
To help ease sinus pain or pressure:
Avoid flying when you are congested.
Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
Try acetaminophen or ibuprofen.
MEDICINE AND OTHER TREATMENTS
Most of the time, antibiotics are not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time it takes for the infection to go away. Antibiotics are more likely to be prescribed sooner for:
Children with nasal discharge, possibly with a cough, that is not getting better after 2 to 3 weeks
Fever higher than 102.2°F (39°C)
Headache or pain in the face
Severe swelling around the eyes
Acute sinusitis should be treated for 5 to 10 days. Chronic sinusitis should be treated for 3 to 4 weeks.
At some point, your provider will consider:
Other prescription medicines
Referral to an ear, nose, and throat or allergy specialist
Other treatments for sinusitis include:
Allergy shots (immunotherapy) to help prevent the disease from returning
Avoiding allergy triggers
Nasal corticosteroid sprays and antihistamines to decrease swelling, especially if there are nasal polyps or allergies
Surgery to enlarge the sinus opening and drain the sinuses may also be needed. You may consider this procedure if:
Your symptoms do not go away after 3 months of treatment.
You have more than 2 or 3 episodes of acute sinusitis each year.
Most fungal sinus infections need surgery. Surgery to repair a deviated septum or nasal polyps may prevent the condition from returning.
Most sinus infections can be cured with self-care measures and medical treatment. If you are having repeated attacks, you should be checked for causes such as nasal polyps or other problems, such as allergies.
Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.