When you get a sinus infection, the sinus cavities in your cheeks, forehead and between your eyes become inflamed and swollen. Unpleasant, but you’re not alone. Sinusitis affects more than 30 million people in the United States each year.

At Yale Medicine, we recognize how much sinusitis can affect day-to-day living. “It is well documented that sinusitis has a significant effect on a person’s overall quality of life,” says R. Peter Manes, MD, an otolaryngologist in the Yale Medicine Sinus & Allergy Program. That’s why we work hard to identify the cause of your sinusitis and offer treatment options you might not find elsewhere.

When the mucus membranes within the sinuses become infected and inflamed, we call this condition sinusitis or rhinosinusitis. The sinuses drain into nasal passages, so a sinus infection can also spread to them. The result is swelling and pain throughout the face, and difficulty breathing.

You can develop a number of symptoms when you have a sinus infection, including:

• Nasal congestion, stuffiness
• Runny nose
• Itchy nose
• Headache
• Discolored or cloudy nasal discharge
• Fatigue
• Pain and pressure in the face
• Swelling around the eyes
• Decreased sense of smell
• Sore throat
• Dry, persistent cough, especially at night
• Fever

Your physician can diagnose sinusitis in three ways: Through a physical exam; using a nasal endoscopy, which is a catheter with a tiny video camera on the end; or by using a computed tomography (CT) scan, which combines X-rays to produce a 3-D image. If your exam or test results show evidence of a sinus infection, your doctor will decide if your symptoms fall into one of two categories based on the cause and how long your symptoms have lasted:

Non-allergic sinusitis: A sinus infection that develops after a cold or virus. There are three main kinds:

• Acute sinusitis: Inflammation and infection in the sinus cavities lasting fewer than four weeks.
• Sub-acute sinusitis: Inflammation and infection lasting four to 12 weeks.
• Chronic sinusitis:  Inflammation and infection lasting for more than 12 weeks.
• Recurrent sinusitis: When a patient experiences four or more episodes a year.

Allergic sinusitis: This occurs when the body’s immune system over-responds to an allergen (something that triggers allergies) such as ragweed, tree pollen, mold spores, animal dander, chemicals or medicines. The body overproduces antibodies, triggering the release of a chemical called histamine, which cases an allergic response. There are two kinds of allergic sinusitis—seasonal or perennial:

• Seasonal allergic sinusitis: When the body’s immune system over-reacts to allergens that are prevalent in a particular season, such as ragweed, tree pollen or mold spores.

• Perennial allergic sinusitis: This year-round condition is caused by an allergic reaction to any number of every day triggers such as dust, pet hair, pollutants or tobacco smoke.

A course of antibiotics usually clears up an acute sinus infection in about seven to 10 days. Some patients benefit from using cough medicine along with antibiotics. Sometimes a prescription nasal steroidal spray is also needed to bring down inflammation.

Patients with rhinosinusitis symptoms may benefit from sinonasal irrigation, using a nasal irrigation device to rinse the nasal passages and sinuses with saline. One of the most popular irrigation devices is the Neti pot, which looks like a small teapot.

For patients with allergic sinusitis, oral antihistamines are recommended—as well as taking tablets or drops under the tongue or under the skin to gradually build a tolerance to an allergen.

When a CT scan shows that a patient has a blockage, deviated septum or small bumps in the nasal lining (nasal polyps) that are causing chronic sinusitis, sinus surgery may be recommended to alleviate the source of the inflammation. 

Our multidisciplinary team, including pulmonary, allergy and immunology experts, allows us to effectively identify causes of sinusitis and develop personalized plans for treatment. Yale Medicine provides cutting-edge medical and surgical therapies, including clinical trials, to optimize treatment of sinusitis.

“Sometimes, sinusitis is the result of a more systemic disease, and our experience in identifying these rare causes allows us to provide the most complete and thorough workup,” Dr. Manes says.

We understand that the symptoms of sinusitis can make your feel lousy and interfere with your daily activities. Our goal is to help you breathe easier and get back to your life.