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Sinusitis is inflammation of the linings of the sinuses that surround the nose. Common symptoms include a tender face and a blocked nose. It's often caused by an infection.

What are sinuses?

The sinuses are air-filled spaces within the bones of your face that open up into the nasal cavity. They’re lined with the same membrane as your nose. This lining is called the mucous membrane and it produces a slimy secretion called mucus to keep the nasal passageways moist and to trap dirt particles and bacteria.
You have four main pairs of sinuses.

  • The maxillary sinuses are in each cheekbone
  • The frontal sinuses are on either side of your forehead, above your eyes
  • The smaller ethmoid sinuses are behind the bridge of your nose, between your eyes
  • The sphenoid sinuses are between the upper part of your nose and behind your eyes.

The location of the frontal, ethmoid and sphenoid sinuses

Sinus frontal max diagram

Symptoms of sinusitis

If you have sinusitis your symptoms may include:

  • pain and pressure in your face, which is worse when you lean forward
  • a blocked nose with green or yellow mucus, which can drain down the back of your nose into your throat and may cause a sore throat and cough
  • a headache.

Less common symptoms of sinusitis include tiredness, a reduced sense of smell, bad breath (halitosis) and a fever.
The pain you have will depend on which of your sinuses are affected.

  • Frontal sinusitis - pain just above your eyebrows, and your forehead may be tender to touch
  • Maxillary sinusitis - your upper jaw, teeth and cheeks may ache and it can be mistaken for toothache
  • Ethmoid sinusitis - pain around your eyes and the sides of your nose
  • Sphenoid sinusitis - pain around your eyes, at the top of your head or in your temples; you may also have earache and neck pain.

A maxillary sinus

On very rare occasions, a sinus infection can spread to the bones of the face or the membranes lining the brain. Also very rarely, sinusitis can spread to form a pocket of pus (abscess) in the eye socket, the brain or a facial bone. If you develop swollen eyelids while you have sinusitis you should see your GP immediately.

How long can sinusitis last?

If your sinusitis lasts less than eight weeks (or less than 12 weeks in a child) it's called acute sinusitis. If it lasts three months or more you may have chronic sinusitis. This is where the lining in your nose and sinuses is thickened and constantly inflamed. The medical terms acute and chronic refer to how long the condition lasts, rather than its severity.

Causes of sinusitis

Sinusitis is often caused by an infection of the mucous membranes with a virus, bacterium or fungus. Most people with acute sinusitis have had a viral infection such as the common cold. During a cold the mucous membranes become swollen and tend to block the openings of the sinuses.
Irritants and allergens can inflame the linings of your nose and sinuses, causing sinusitis. Some examples of irritants include:

  • airborne allergens such as grass and tree pollen
  • smoke and air pollution
  • sprays containing chemicals, such as household detergents.

Enlarged adenoids and growths on the mucous membranes, such as nasal polyps, may block the openings to the sinuses and cause sinusitis.
People with certain medical conditions, such as cystic fibrosis, are more likely to get sinusitis.

Diagnosis of sinusitis

Your GP will ask you about your symptoms and will examine you. They may also ask you about your previous illnesses and operations. They’ll usually be able to diagnose acute sinusitis just from examining you and no further medical tests will be necessary.

If you have chronic sinusitis and if your treatments haven't worked, your GP may refer you to a doctor who specialises in ear, nose and throat conditions. You may have an X-ray to help determine the cause of your chronic sinusitis. The specialist may recommend a nasendoscopy (also known as nasal endoscopy), where he or she will insert a small, flexible tube with a light and a camera lens at the end (endoscope) into your nostril to look at the inside of your sinuses.

Treatment of sinusitis

Most people with acute sinusitis get better without treatment. However, if your symptoms continue for more than a week, or seem to be worsening, see your GP.


There is some evidence that using salt-water nasal sprays or drops to irrigate the nose may help with the symptoms of chronic sinusitis. These are available from pharmacies without a prescription.

You can also make your own salt water spray by filling an empty nasal spray container filled with saline, bought commercially or with a solution you make yourself. The Australasian Society of Clinical Immunology and Allergy recommends using the following proportions: two teaspoons of salt and one teaspoon of baking soda or sodium bicarbonate to one litre of water. Allow to cool before using.

Whichever preparation you use, whether store-bought or homemade, it’s important to use a correct method to irrigate your nose. You should pump two to six sprays into the nostril then tilt your head to the right for 10 seconds, then to the left for 10 seconds, and then pinch the nose and lean forward for 10 seconds. This will help with nasal drainage.

Some people find that breathing in steam from a bowl of hot (but not boiling water) or sitting in the bathroom with the hot shower running provides some relief from the symptoms. However, this isn't scientifically proven. Putting a warm flannel on the areas of your face that are painful and sleeping with your head and shoulders propped up with pillows may help, but so far there isn’t any scientific evidence that this works.


Over-the-counter painkillers such as ibuprofen or paracetamol may relieve pain and bring your temperature down if you have a fever. Always read the accompanying consumer medicines information leaflet and ask your pharmacist or doctor for advice.

Several nasal sprays are available over-the-counter and on prescription from your GP. These include decongestants and mild steroids. According to the Australasian Society of Clinical Immunology and Allergy, overuse of decongestant nasal sprays may increase the risk of sinusitis. So talk to your GP or local pharmacist about the most appropriate remedies and treatment duration for you.

If your GP thinks your sinusitis is caused by a bacterial infection, or you develop a secondary bacterial infection due to your inflamed sinuses, they may prescribe antibiotics. However, research shows that 80 percent of people with acute sinusitis get better within two weeks without antibiotics.

If you have sinusitis and an allergy, you may find that controlling your allergy helps to reduce the symptoms of your sinusitis. Antihistamine tablets may help to do this.


If you have chronic sinusitis that doesn't get better with home or medical (drug) treatments, your specialist may suggest that you consider surgery.

In functional endoscopic sinus surgery the surgeon washes out the sinuses and widens the drainage holes using an endoscope. This can be done under local or general anaesthesia.

Other types of surgery can remove nasal polyps or correct an obstruction in the nose that may be the cause of your sinusitis. Talk to your doctor for more information about the different types of surgery that may be suitable and to understand the risk of complications and side-effects.

Further information

The Australasian Society of Clinical Immunology and Allergy


Aerospace Medical Association. Medical guidelines for airline travel. 2nd ed. Aviation, Space and Environmental Medicine. 2003; 74(5): Section II (supplement).

Ahovuo-Saloranta A Borisenko OV Kovanen N et al. Antibiotics for acute maxillary sinusitis. Cochrane Database Systematic Reviews. 2008; Issue 2. doi:10.1002/14651858.CD000243.pub2

American Academy of Otolaryngology - Head and Neck Surgery. Sinusitis. [online] Alexandria, VA: American Academy of Otolaryngology - Head and Neck Surgery. c2011 [accessed 4 Jul 2011] Available from:

Australasian Society of Clinical Immunology and Allergy (ASCIA). Sinusitis and allergy. [online]Balgowlah, NSW: ASCIA. Jan 2010 [accessed 4 Jul 2011] Available from: (PDF, 85.1Kb)

Clinical Knowledge Summaries. Common cold. [online] London: National Institutes for Health and Clinical Excellence. 2007 [last updated Mar 2009, accessed 4 Jul 2011] Available from:

Harvey R Hannan SA Badia L et al. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Systematic Reviews. 2007; Issue 3. doi:10.1002/14651858.CD006394.pub2

Merck Manuals Online Medical Dictionary. Preseptal and orbital cellulitis. [online] Whitehouse Station, NJ: Merck, Sharp and Dohme Corp. [Last updated Sept 2008, accessed 4 Jul 2011] Available from:

National Institute of Allergy and Infectious Diseases (NIAID). Sinus infection (Sinusitis). [online] Bethseda, MD: NIAID. [Last updated Mar 2011, accessed 4 Jul 2011] Available from:

National Prescribing Service (NPS). Management of allergic rhinitis. [online] Surry Hills, NSW: NPS. Sept 2001 [Accessed 4 Jul 2011] Available from: (PDF, 174Kb)

Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press, 2010
Zalmanovici A Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database of Systematic Reviews. 2009; Issue 4. doi: 10.1002/14651858.CD005149.pub3

Last published: 30 July 2011

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