Some Sinusitis Symptoms Are Similar to the Common Cold

If you have a cold, you probably have a runny nose, congestion, and postnasal drip—but these symptoms also might be caused by a sinus infection.

“Your sinuses are air pockets that are lined with mucosal tissue. They help humidify, filter, and warm the air you breathe in, and they act as part of the immune system by clearing pathogens, such as bacteria,” says Abtin Tabaee, MD, an otolaryngologist at Weill Cornell Medicine.

The sinuses are lined with microscopic hair-like cells called cilia, which help clear mucus from the sinus passages through small openings called “outflow tracts.” The sinuses also act as a cushion or buffer to help protect the skull and brain in the event of trauma to the face.

Types of Sinusitis

If your sinuses become infected, you have sinusitis; the medical term for this condition is “rhinosinusitis.” There are different types of sinusitis; the type determines the course of treatment.

Symptoms of all types of sinusitis may include a runny nose, postnasal drip, congestion (blocked or stuffy nose), pain or pressure around the eyes, cheeks, nose, or forehead, headache, and fatigue. Other symptoms include cough, fever, a feeling of pressure in the ears, and a decreased sense of smell.

Acute bacterial rhinosinusitis is of limited duration; it most often occurs as a complication of a viral upper respiratory tract infection, such as the common cold.

“The average person has two to three episodes of viral upper respiratory tract infections per year; a small percentage of these infections develop into bacterial sinusitis events,” explains Dr. Tabaee.

Another type is recurrent acute sinusitis: having four or more bacterial infections in a 12-month period, with complete resolution between episodes.

Chronic Sinusitis

A person who has chronic sinusitis has persistent symptoms continually for three months or longer. A hallmark of chronic sinusitis is inflammation of the nasal and sinus passages. Contributing factors may include allergies, poor immune function, the presence of polyps (noncancerous growths), and narrow sinus cavities.

“Chronic sinusitis produces a self-perpetuating cycle of tissue injury and sinus dysfunction, which leads to further tissue inflammation and a more hospitable environment for pathogenic bacteria,” explains Dr. Tabaee.

Viral or Bacterial?

Most episodes of acute sinusitis are caused by a virus, but some are caused by bacteria.

“A person with a viral infection generally recovers within a week. The tip-off to a bacterial infection is that symptoms persist for up to two weeks,” says Dr. Tabaee. “Another sign of a bacterial infection is the ‘double peak’ phenomenon, in which symptoms improve after about a week and then become worse again.”

Bacterial infections are treated with antibiotics and nasal steroid sprays.

For viral infections, stay hydrated by drinking plenty of fluids, and get adequate rest. Over-the-counter medications can be taken to manage symptoms, but antibiotics are not needed: Antibiotics work on bacteria but not on viruses.

Most people who have acute sinus infections are treated by their primary care physician. However, if your condition is persistent or recurrent, Dr. Tabaee recommends seeing an otolaryngologist (an ear, nose, and throat doctor).

Surgical Treatment

If chronic sinusitis can’t be controlled with medication, minimally invasive surgery may be needed.

“Surgery for sinusitis has few risks, but it can result in a significant improvement in the condition and the patient’s quality of life,” says Dr. Tabaee.

The most common surgery involves widening of the natural sinus outflow tracts and clearance of any obstructed bone and soft tissues. The procedure does not require any incisions.

Another technique, balloon dilation, involves inserting and inflating a balloon catheter that expands the natural outflow tracts.

If you have recurrent episodes of sinusitis or you have had symptoms for more than three months, see a doctor.

“Many patients with chronic sinusitis have been sick for so long that they are often amazed at how good they feel after receiving treatment,” explains Dr. Tabaee. “As well as getting relief from their sinus symptoms, they often report more energy, a better mood, and improvements in virtually all aspects of their lives.”

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