Sinusitis

Sinusitis is inflammation of the sinuses — the air-filled spaces in the cheekbones, forehead and around the nose. Most cases are viral (follow a common cold) and settle in 7-10 days without antibiotics.

Types

• Acute sinusitis — less than 4 weeks; usually follows a cold.
• Sub-acute — 4-12 weeks.
• Chronic sinusitis — over 12 weeks; often with allergies, nasal polyps, or a deviated nasal septum.
• Recurrent — 4 or more episodes a year.

Symptoms

• Pain or pressure over the cheeks, forehead, or around the eyes — often worse leaning forward.
• Nasal blockage, thick yellow/green discharge.
• Reduced sense of smell.
• Post-nasal drip, cough worse at night.
• Fever (often in acute cases).
• Headache, bad breath, ear pressure.

Red flags — see a Health Expert urgently

• Swelling or redness around the eye.
• Severe headache, stiff neck, confusion.
• Vision changes.
• High fever with severe facial pain.
• Symptoms worsening after initial improvement ("double sickening").

Treatment

• Most acute cases need only supportive care — rest, fluids, warm steam inhalation, saline nasal rinses, simple pain relievers, decongestant sprays for 3-5 days max.
• Antibiotics — only for bacterial sinusitis, usually when symptoms last more than 10 days or severe from the start. Most sinusitis does not need antibiotics; overuse is a major driver of antibiotic resistance in India.
• Chronic or recurrent sinusitis — address underlying allergies; nasal steroid sprays are first-line; an ENT specialist assesses for structural causes.
• Surgery (FESS) — for structural blockages or polyps, after medical therapy.

India-specific prevention

Air pollution, dust, and pollen all worsen sinus symptoms. Saline nasal rinses (with clean boiled and cooled water, or a sterile saline sachet) are simple and effective. If you have allergies, treating them reduces sinusitis episodes. Avoid routine over-the-counter antibiotic or steroid nasal sprays — see a Health Expert for persistent symptoms.