Diagnosis

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Typically, a cold lasts no more than seven to 14 days and goes away without treatment. However, when symptoms persist or don't respond to over-the-counter decongestants, this suggests that a bacterial infection has developed. Acute sinusitis can clear up on its own after several weeks. Antibiotic treatment is often used to decrease the duration and severity of sinusitis-associated symptoms. As with all medical conditions, proper diagnosis is important before starting treatment.

To diagnose sinusitis, a health care professional will typically take a medical history, examine the inside of your nose and examine your sinuses by gently pressing on them to see if they are painful or swollen. During the history, the health care professional will give special attention to previous episodes of sinus infections, asthma, allergies or other upper respiratory tract conditions. He or she may order a computerized tomography (CT) scan, a type of x-ray, of the sinuses.

Hallmark symptoms of sinusitis include:

• pain in the cheeks, forehead or around the eyes (often, these areas are painful to the touch), upper jaw, teeth, neck, ears or deep pain at the top of your head

• headache in the morning

• puffy, swollen eyelids and tissue around the eyes

• nasal stuffiness and congestion to the point that you can't breathe

• greenish mucus

• post-nasal drip

• cough (which may get worse at night)

• runny nose

• sore throat

• slight fever

• weakness

• fatigue

• loss of sense of smell

Fever of greater than 103 degrees Fahrenheit, pain or swelling, red cheeks, redness around your eyes, severe headaches, confusion or a stiff neck are symptoms that need immediate attention by a health care professional.

Chronic sinusitis is a common problem for people with allergies or asthma. Chronic sinusitis is usually characterized by sinus inflammation that persists for eight weeks or more.

Chronic sinusitis can be caused by a variety of different things including:

• a blockage of the sinus openings due to allergic disorders of the nose or structural blockage, like a deviated nasal septum

• problems with the movement of mucus

• a weakened immune system

• asthma

• allergies

Allergies and infections contribute to chronic sinusitis by keeping the sinus membranes inflamed. Because of the swelling and inflammation, the sinus membranes thicken and exacerbate the obstruction and infection. The symptoms of sinusitis may also be triggered by exposure to strong-smelling chemicals, cigarette smoke, pollution, dust, mold or even strong perfume in susceptible individuals.

Structural disorders of the respiratory tract may also cause chronic sinusitis. For example, narrow drainage passages in your nose, a deviated septum or nasal polyps (growths that block the sinus passages) can all contribute to the condition.

During an examination, a health care professional should carefully assess any anatomical abnormalities that could be causing chronic sinusitis. Nasal polyps are typically non-cancerous, but they can cause obstruction. Nasal steroids will often reduce the size of the polyps, but when obstruction persists, they may need to be removed. A variety of cancerous growths, although rare, are possible and require immediate treatment. They can cause nasal obstruction or bloody nasal discharge.