Sinusitis

What is sinusitis?

The sinuses are hollow cavities in the skull surrounding the nose. When these become inflamed — typically following a viral infection — the lining swells and mucus cannot drain properly, creating the pressure, pain, and congestion of sinusitis. Acute sinusitis lasts up to 4 weeks; subacute 4–12 weeks; chronic sinusitis persists beyond 12 weeks.

Most acute sinusitis is viral and does not require antibiotics. However, bacterial sinusitis — characterised by worsening symptoms after initial improvement, severe facial pain, and high fever — does warrant antibiotic treatment.

Symptoms

• Facial pain or pressure — around the forehead, cheeks, nose, and around the eyes
• Nasal congestion and blockage
• Thick yellow or green nasal discharge
• Reduced or absent sense of smell
• Postnasal drip — mucus trickling down the back of the throat
• Headache and dental pain — particularly upper back teeth
• Fever and fatigue
• Cough — from postnasal drip irritating the throat

Causes

• Viral upper respiratory infections — the most common trigger
• Bacterial infection — secondary to viral sinusitis
• Allergic rhinitis — persistent nasal inflammation causes recurring sinusitis
• Nasal polyps — block sinus drainage pathways
• Deviated nasal septum — impairs drainage
• Dental infections — upper molar root infections can directly infect the maxillary sinus
• Swimming in polluted water

When to see a doctor

See a doctor if symptoms are severe, worsening after initial improvement, or not resolving after 10 days. Also seek assessment for recurrent sinusitis (more than 4 episodes per year) or chronic symptoms lasting beyond 12 weeks. Seek urgent care if there is severe headache, high fever, visual changes, or a stiff neck.

Treatment options

• Saline nasal irrigation — very effective at clearing mucus and reducing symptoms
• Intranasal corticosteroid sprays — reduce inflammation and improve drainage; first-line for chronic sinusitis
• Decongestants — short-term relief (maximum 5–7 days to avoid rebound congestion)
• Pain relief — paracetamol or ibuprofen for facial pain and fever
• Antibiotics — only for bacterial sinusitis; amoxicillin or co-amoxiclav are first-line
• Functional endoscopic sinus surgery (FESS) — for chronic sinusitis not responding to medication
• Treating underlying causes — managing allergies, removing polyps

How eMedClinic can help

Our doctors assess sinusitis symptoms, distinguish viral from bacterial causes, prescribe appropriate treatment, and refer for imaging or ENT assessment where recurrent or chronic sinusitis requires further investigation. Online consultation is ideal for sinusitis — get guidance and a prescription without leaving home when you are feeling unwell.