Sinusitis diagnosis

It’s important that you see your healthcare provider if you believe that you or your child has a sinus infection. Your healthcare provider will likely begin your diagnosis^[10] by consulting your medical history. He or she will then generally proceed with a physical examination that includes looking in your nose for signs of growths or polyps, shining a light against the sinus to check for signs of inflammation, or tapping over a sinus area to locate an infection. An ear, nose, and throat specialist (ENT) may also view your sinuses through a fiberoptic scope (which is called a nasal endoscopy or rhinoscopy) in order to diagnose sinusitis. A healthcare provider may also conduct one of the following imaging tests to decide your treatment:

• A CT scan of the sinuses, which can help diagnose a sinus infection and provide a closer view of sinus bones and tissues
• A MRI of the sinuses, which may indicate the presence of a tumor or fungal infection

Further testing may be performed if you or your child’s sinus infection is persistent. These tests can include:

• Allergy testing
• Testing for cilia function
• A nasal culture
• Nasal cytology (evaluation of nasal cell function)
• Testing for cystic fibrosis
• Blood tests for HIV or other immunocompromising conditions

As always, consult your healthcare provider if you or your child present new or worsening symptoms of a sinus infection.

Chronic sinusitis

Chronic sinusitis—also known as chronic rhinosinusitis—is defined as inflammation of the sinuses that lasts for three months or longer despite medical treatment. It can affect anyone from children to adults. While chronic sinusitis is characterized by the long-lasting presence of symptoms, it can begin as several episodes of short-term acute sinusitis before developing into a chronic illness. Chronic sinusitis and acute sinusitis share many symptoms in common. However, while acute sinusitis is temporary and most frequently caused by a cold, chronic sinusitis is prolonged, and can be the result of infection, nasal polyps (growth in the sinuses), or swelling of the sinuses’ lining. Symptoms of chronic sinusitis can include:

• Nasal inflammation
• Thick, discolored nasal discharge
• Mucus drainage down the back of the throat (postnasal drip)
• Congestion or nasal obstruction that can cause difficulty breathing through the nose
• Pain, tenderness, or swelling around the eyes, cheeks, nose, or forehead
• Reduced senses of smell and taste

Other less common symptoms of chronic sinusitis include:

• Earache
• Aching in the upper jaw or teeth
• Cough or persistent throat clearing
• Sore throat
• Bad breath
• Fatigue

It’s wise to make an appointment with your healthcare provider if you or your child has:

• Had multiple instances of sinusitis that do not respond to medical treatment
• Had a sinus infection lasting for more than 10 days
• Symptoms of a sinus infection that don’t improve after seeing a provider

More concerning symptoms that may call for immediate attention include:

• Fever
• Swelling or redness around the eyes
• Severe headache
• Swelling in the forehead
• Confusion
• Double vision or changes in vision
• Stiff neck