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	Sinusitis
	Definition
	Sinusitis is an acute infection of the sinuses' mucous membranes.
	Cause
	Sinusitis is usually a complication of a cold or other viral infection of the nose and throat, although some cases may follow dental treatment. In a few instances, sinusitis is associated with hay fever or anatomical obstructions that block drainage of fluids. The organisms causing sinusitis are Streptococcus pneumoniae, Haemophilus influenzae (nontypeable), and Branhamella catarrhalis. Even though it usually follows a viral infection, sinusitis most often is a bacterial infection. This condition occurs after viruses change the characteristics of the cells lining the sinuses, allowing normally harmless bacteria that enter through the nose and mouth to settle and multiply. Long episodes of infection can lead to irreversible changes in the mucosal lining of the sinuses and result in chronic sinusitis. If a person has undergone a Caldwell-Luc procedure (an emergency treatment to drain the sinuses), the mouth bacteria, which can grow in the absence of air (anaerobic), may migrate to the sinus cavities and cause a different type of sinusitis.
	Diagnosis
	The symptoms of sinusitis are facial pain, headache, yellowish discharge from the nose, obstruction of smell, and a nasal speaking tone. If the frontal sinuses over the eyes are involved, there can be swelling of the eyelids and excessive tearing. In almost all older children and in about half of adults, there will also be fever. Sinusitis is difficult to distinguish from a cold. The doctor should carefully examine the throat, nose, ears, sinuses, and teeth. In a dark room, the doctor will shine a light in the mouth to see if it shows up in the maxillary sinuses behind the cheekbones and in the frontal sinuses. Lack of "transillumination" probably indicates infection. X-rays will reveal trapped air and fluid and thickened mucosal walls of the sinuses. Culturing nasal secretions is of little value. In severe cases, a fluid sample will be taken from the sinuses via a needle passed through an anesthetized facial area; this will relieve pressure and provide material for a culture so that the infectious agent can be identified.
	Treatment
	If the infection is bacterial, an antibiotic such as amoxicillin or a cephalosporin will be prescribed. In severe cases, the sufferer may be hospitalized for intravenous administration of more powerful antibiotics. All drugs must be taken for at least 10 days. If the pain is severe, codeine may be prescribed. Using decongestant nose drops and inhaling steam may be helpful in many cases. Unfortunately, once sinusitis becomes chronic, there often is permanent mucosal damage. This may require surgery to promote drainage and remove excess mucosal tissues.
	Prevention
	There are no proven ways to prevent acute sinusitis. Prompt administration of decongestants when sinusitis symptoms develop or during bouts of the common cold, flu, and other upper respiratory infections may be helpful. Allergies should be well controlled. Good dental hygiene and prompt treatment of tooth problems will reduce the chance of sinusitis developing as a complication of dental disease. Some people are anatomically predisposed to sinusitis and may need surgery to correct the initial problem and prevent this condition.
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