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Sinusitis Patient Education Series

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Sinusitis is an infection or inflammation of the lin- ing of the air-filled cavities in the skull. These air- filled cavities are located above the eyebrows in the forehead, behind the nose, and just below the eyes. They drain into the nose. The most common cause of acute sinus pain is a viral infection of the respira- tory tract leading to obstruction of the drainage of these sinuses. The key distinction between a cold and sinusitis is that the nasal congestion and other symptoms of a cold begin to improve within 5 to 7 days. The symptoms of sinusitis, however, last longer and may even worsen with time.
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  • Added: October, 05th 2009
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Patient Education Series
What is sinusitis?
Sinusitis is an infection or inflammation of the lin-
allergies with steroid nasal sprays. Long-term anti-
ing of the air-filled cavities in the skull. These air-
biotics may be required to eliminate a chronic sinus
filled cavities are located above the eyebrows in the
forehead, behind the nose, and just below the eyes.
They drain into the nose. The most common cause
Once treatment for sinusitis has begun, you should
of acute sinus pain is a viral infection of the respira-
return to Health Services if you have increased head-
tory tract leading to obstruction of the drainage of
ache or facial pain, high fever, or if symptoms are not
these sinuses. The key distinction between a cold
improving after 4 or 5 days of treatment.
and sinusitis is that the nasal congestion and other
symptoms of a cold begin to improve within 5 to 7
Is there a way to prevent sinusitis?
days. The symptoms of sinusitis, however, last longer
Nasal irrigation, with a salt-water spray such as
and may even worsen with time.
“Ocean” or a Neti Pot is very helpful in both the
prevention and the treatment of sinusitis. A Neti
What are the symptoms of sinusitis?
Pot is a small teapot shaped vessel that can be pur-
Sinusitis symptoms begin with fullness of the involved
chased at pharmacies, including our Health Services
sinuses, nasal discharge and cold symptoms. The
obstruction of the sinuses leads to a bacterial infec-
tion in the sinuses themselves. When this happens,
symptoms typically become more severe and may in-
clude fever, chills, increased pain and tenderness over
Why is nasal irrigation helpful?
the involved sinuses. This is often accompanied by
Irrigating or spraying the nose with salt water—such
a thick, yellow/green and sometimes blood streaked
as with saline nasal sprays that are purchased in the
nasal discharge. Sometimes the pain over the sinus
pharmacy without prescription—is useful for clean-
changes in intensity with changes in position. There
ing mucous out of the nasal passages and relieving
may also be a loss of taste and smell, and aching of
nasal congestion. With proper use of an inexpensive
the upper teeth if the infection is severe.
device called a Neti Pot, it is possible to irrigate the
sinus cavities. When a strong salt-water solution is
How is sinusitis treated?
used, the sinuses are stimulated to expel mucous that
Acute bacterial sinusitis is usually treated with anti-
is trapped and stagnating. This results in a “runny
biotics, anti-inflammatories (Advil), decongestants,
nose” that may last for 10 or 15 minutes, after which
mucolytics, steroid nasal sprays and hot compresses
the sinuses are relatively empty with less material to
on the sinuses. It also helps to elevate the head and
drain out and cause postnasal drip. In addition, germs
use humidifier while sleeping. Prevention of sinusitis
tend to breed in this mucous, so the less mucous there
can sometimes be accomplished by treating a cold
is, the less likely it is that you will get a sinus infec-
early on with fluids, humidified air, hot compress to
tion. The whole process is simple, comfortable and
the sinuses and rest.
quick. After you do it once or twice, it should require
no more than one minute to complete an irrigation
Chronic sinusitis is often more difficult to diagnose.
from start to finish.
Symptoms are less severe, and post-nasal drip or drain-
age is often the only symptom of chronic sinusitis.
One or 2 minutes a day spent performing nasal irriga-
Chronic frontal headaches, obstruction of the nasal
tion is often more effective than weeks and weeks of
airway and tenderness over any of the sinuses may
antibiotics, decongestants, and cortisone nasal sprays,
also indicate chronic infection. In many instances, a
and has none of the side effects of these medications.
patient has a background of allergies or exposure to
Even if you do require medications or surgery, the
cigarette smoke, and the treatment of chronic sinusitis
improved cleanliness of the sinuses makes it more
is often directed towards treatment of the underlying
likely that these treatments will be effective.
Brown University Health Services ? ? 863-3953

How do I irrigate?
How often should I irrigate?
First, it is important not to use common table salt to
After you do this a while, you’ll find what works best
irrigate the nose on a regular basis, because it contains
for you (and it does vary from one person to the next).
certain chemicals such as iodine and “anti-clumping”
Start off irrigating once in the morning and once in
additives that can be harmful if used frequently. You
the evening. There is no harm in doing it 3 to 4 times
can use Kosher salt (found in most groceries right
a day and it may be useful to do so if you have a lot
along with the table salt) or sea salt found in health
of drainage. If after a week or so your nose seems
food stores.
much clearer and you are not having much drainage
during the day, reduce it to just one irrigation in the
With a measuring spoon, add 1 teaspoon of salt to
morning. You may continue this indefinitely, or you
the Neti Pot and fill it with warm tap water. Stir very
may only irrigate when you feel the congestion or
thoroughly. The salt water usually doesn’t sting but
postnasal drip is recurring.
the salt particles will if they are not dissolved well.
You can use a little less than a teaspoon at first if it
feels more comfortable, but after a few days there
Hot Compresses
should be no discomfort at all and you can mix it a
Hot compresses to the sinuses also help as they pro-
little stronger.
mote movement of the tiny hairs that line the nasal
cavity, cleaning mucus and pus. Simply moisten a
Lean over the sink, tilt your head to one side (it should
facecloth with warm water and lay across forehead
be almost flat—one ear up and one ear down), and
(above the eyes) and/or cheekbones for 5 minutes
put the spout of the Neti Pot into the upper nostril.
three times a day. Placing a dry facecloth over the
Pour the salt water slowly into your nose while you
heated wet one will help retain heat for the full 5
continue breathing through your mouth. The water
will flow into the upper nostril, turn the corner at
the back of the nose, and trickle back out the lower
nostril. When the pot is about half empty, stop, turn
your head the other way and repeat the process.
Let the water drip out, then gently blow your nose.
You will probably need to blow it several times in the
next few minutes as your sinuses drain.
Brown University Health Services ? ? 863-3953

Sinusitis Patient Education Series



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