The bones behind and above your nose contain air spaces. The air spaces are your sinuses. One set is located above the space between your eyebrows and extends to a point just above the arch of your eyebrows. This set is called your frontal sinuses. Another set is located one of either side of your nose and below your cheekbones. This set is known as your maxillary sinuses. When the mucous membranes of these air sacs become inflamed, you have sinusitis. The inflammation can be the result of a viral or bacterial infection. This is more likely to happen with the frontal sinuses than with the maxillary sinuses. Sinusitis usually follows a cold. You will notice that after a few days when you are expecting your cold to get better the congestion in your nose worsens and the discharge increases. Then your nose becomes more congested, there is no discharge and you are breathing through your mouth. If the inflammation is located in the frontal sinuses, you might have a headache just above your eyes and your forehead feels tender in this spot. You will feel the pain the most when you first awaken in the morning and anytime you bend your head down.
When the inflammation is located in the maxillary sinuses, one or both cheeks hurt. You can also feel as though you have a toothache in your upper jaw. This can also accompany a tooth infection as the infection spreads from the root of your tooth into one of the maxillary sinuses. It varies among the population. Some people never have it and others are very susceptible. They will get it every time they have a cold. A physician will prescribe an antibiotic for sinusitis. A cold is a viral infection but sinusitis is a bacterial infection and responds to treatment with antibiotics.
Prior to the discovery of antibiotics sinusitis was a risky disease as the infection could spread into the bones and to the brain. These complications do not occur today so with proper treatment with antibiotics, there is no risk associated with sinusitis. In addition to the antibiotic a physician might also prescribe nose drops, decongestants or a nasal spray. Decongestants shrink the inflamed membrane and that widens the air passage. However, it is important that the decongestant be used exactly as prescribed. A decongestant can actually be harmful if not used correctly.
When sinusitis is persistent the physician may do X rays. On an X ray a healthy sinus appears as a dark patch surrounded by gray bone. If sinusitis is present the fluid will show up as white areas. The physician can then perform minor surgery under local anesthetic during which a bone is pierced between the nose and the sinuses to create another passageway. The sinuses are then washed out with sterile water and the removed material is analyzed to determine the nature of the infection and how to combat it. If the sinusitis becomes chronic, additional minor surgery may be required to improve drainage. This is a very rare situation.
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