If you’ve ever experienced a persistent stuffy nose, facial pressure, or thick nasal discharge, you may have dealt with sinusitis. With recent updates from the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), we want you to have a better understanding of sinusitis and its management, to help you feel better faster and avoid unnecessary treatments.
What Is Sinusitis?
Sinusitis is inflammation of the sinuses—air-filled spaces in your skull located behind your forehead, cheeks, and eyes. When the sinuses are blocked or filled with fluid, bacteria, viruses, or fungi can grow, leading to infection or chronic inflammation.
There are two main types of sinusitis:
Acute Sinusitis
- Symptoms last less than four weeks.
- Often caused by viral infections like the common cold.
- Usually resolves on its own.
Chronic Sinusitis
- Symptoms persist for 12 weeks or longer.
- Can result from ongoing inflammation, allergies, nasal polyps, or repeated infections.
- May require more targeted medical or surgical treatments.
Common Symptoms of Sinusitis
Sinusitis can affect daily life and may include:
- Nasal congestion or blockage
- Thick nasal discharge (yellow or green)
- Facial pain or pressure, especially around the cheeks, eyes, or forehead
- Headache
- Reduced sense of smell or taste
- Fatigue
- Fever (more common in acute bacterial sinusitis)
Causes of Sinusitis
- Viral infections: The most common cause of acute sinusitis.
- Bacterial infections: Less common, often following a viral infection.
- Allergies: Seasonal or environmental allergies can inflame the nasal passages.
- Structural issues: Deviated septum or nasal polyps can block sinus drainage.
- Environmental factors: Pollution, smoke, and dry air may trigger sinus inflammation.
Evidence-Based Treatments
The AAO-HNS guidelines provide updated recommendations for the management of sinusitis:
- Watchful Waiting for Mild Cases
- Not all sinus infections require antibiotics.
- For uncomplicated acute sinusitis, waiting 10 days before starting antibiotics is recommended.
- Antibiotics When Needed
- Only prescribed for bacterial sinus infections with severe, worsening, or prolonged symptoms.
- Helps prevent unnecessary antibiotic resistance and side effects.
- Nasal Irrigation
- Saline sprays or rinses can reduce congestion and promote sinus drainage.
- Safe for both acute and chronic cases.
- Medications for Symptom Relief
- Decongestants: Short-term relief for nasal blockage.
- Pain relievers: Help reduce facial pain or headache.
- Oral or nasal steroids: Recommended for severe inflammation, especially in chronic sinusitis.
- Surgery
- Considered when chronic sinusitis does not respond to medical treatments.
- Procedures aim to improve sinus drainage and reduce blockage.
- Inclusion of Aspirin-Exacerbated Respiratory Disease (AERD)
- AERD has been added as a chronic condition that can modify the management of chronic rhinosinusitis (CRS). This inclusion highlights the need for tailored treatment strategies for patients with this condition.
- Guidance on Antibiotic Use in CRS
The guidelines advise against the routine use of antibiotics for CRS without exacerbation or as a prerequisite for sinus imaging or surgery. This recommendation aims to prevent unnecessary antibiotic exposure and its associated risks.
- AERD has been added as a chronic condition that can modify the management of chronic rhinosinusitis (CRS). This inclusion highlights the need for tailored treatment strategies for patients with this condition.
The Role of Allergists in Sinus Health
Allergies are a common trigger for sinus inflammation. An allergist can help:
- Identify specific allergens through testing
- Prescribe medications or allergy shots (immunotherapy)
- Provide strategies to reduce allergen exposure at home and work
Addressing allergies can prevent recurrent sinus infections and improve overall sinus health. Our expert allergists at NY Allergy & Sinus Centers are here to help identify and provide solutions to any allergies you amy have.
When to See a Doctor
Seek medical attention if you experience:
- Symptoms lasting more than 10 days without improvement
- High fever or severe facial pain
- Recurrent sinus infections
- Signs of complications, such as vision changes or swelling around the eyes
Early evaluation and treatment can prevent complications and improve your quality of life.
Take Charge of Your Sinus Health
Sinusitis can be uncomfortable and disruptive, but the latest AAO-HNS guidelines make it clear that many cases can be managed effectively with careful monitoring, symptom relief, and allergy-focused care. Whether your sinus issues are occasional or chronic, getting the right evaluation is key to preventing complications and improving your quality of life.
At NY Allergy & Sinus Centers, our team of specialists follows these updated guidelines to provide personalized care. From allergy testing and treatment to advanced management of chronic sinusitis, we’re here to help you breathe easier and feel better.
Don’t wait for your symptoms to worsen—schedule an appointment today and take the first step toward healthier sinuses.