Millions of Americans, adults and children, suffer with sinusitis each year. Sinusitis may be acute (lasting two to three months) or chronic (lasting more than three months), allergenic or nonallergic.
Sinuses are hollow air filled cavities found within the bones behind your cheeks, forehead and eyes. The sinuses make mucus, which cleans bacteria and other particles from the air you breathe.
Symptoms of nonallergic sinusitis lasting anywhere from a few hours to a few days may include:
- Severe runny or stuffy nose
- Clear or slightly colored mucus
- Post nasal drip with a persistent cough
- Facial pain, swelling and pressure
- Altered sense of smell
In some cases, no relief may be found or symptoms worsen with the use of over-the-counter medications.
Causes and Risk Factors
People who are sensitive to dust, smog, smoke, strong odors and chemicals may experience nonallergic sinusitis. Temperature changes, along with changes in humidity and stress may also be triggers.
Other causes may include:
Infections - Viral infections, such as a cold or flu, may trigger nonallergic sinusitis. Though the attack may last a short time, patients often experience ongoing post-nasal drip, discolored mucus, facial pressure and pain.
Hormones - Pregnancy, menstruation, menopause, hypothyroidism and oral contraceptive use may trigger a nonallergic sinusitis reaction.
Diet - Alcoholic beverages and hot, spicy foods may result in a nonallergic sinusitis attack.
Drugs - Anti-inflammatory drugs such as aspirin and ibuprofen, beta-blockers, sedatives, antidepressants, erectile dysfunction drugs and, in many cases, overuse of decongestant nasal sprays, may bring on nonallergic sinusitis
To rule out allergic sinusitis, a physician will typically run blood and/or skin tests. Skin tests measure a person's reaction to a particular allergen (such as dust mites, pollen, animals, etc). Blood tests measure the body's immune system response to common allergens.
Other diagnostic tests to aid in evaluating a patient's symptoms may include a Nasal endoscopy, a procedure within which a flexible tube is inserted into the nasal passages and a fiber-optic light enables the physician to see even the smallest abnormality
Also, a computed tomography (CT) scan of the sinus can help a physician assess infections, injuries or other abnormalities.
If symptoms are mild, patients may find relief with over-the-counter remedies such as:
- Oral decongestants
- Nasal sprays - saline, antihistamine, decongestant nasal sprays
- Nasal rinses to keep the nose free of irritants
- Room humidifiers
- An increase in the consumption of water, juice or decaffeinated beverages
- Gentle and regular nose blowing
- Avoiding known or suspected triggers
In addition to some of the treatments above, chronic nonallergic sinusitis may be treated with:
Balloon Sinuplasty - Similar to balloon angioplasty used to break up blood clots in the arteries in the heart, balloon sinuplasty utilizes small balloons to expand the openings of the sinuses. This procedure is less invasive than traditional surgery to restore normal sinus drainage and the benefits may include less pain, bleeding and swelling with a quicker return to normal activities.
Endoscopic Sinus Surgery - When treatments or medications aren't effective, endoscopic sinus surgery may be an option. A flexible tube is inserted into the nasal passages and fiber-optic light allows the doctor to see the smallest of abnormalities in the sinuses. At this time, problem tissue or polyps that may be causing the nasal blockage can be removed.
Cedars-Sinai has a range of comprehensive treatment options.