Sinusitis refers to inflammation of the sinuses due to an infection. Sinus infections can be caused by a virus, bacteria or fungus (mold). There are a total of four pairs of sinuses in our facial area once we reach eight years of age. We are born with two sets of sinuses, the ethmoid and maxillary sinuses. After we reach eight years of age, most of us have developed the additional frontal and sphenoid sinuses. In a twenty four hour period the sinuses and the nose produce two liters of mucous, one liter during the day and one liter during the night. If you are clearing your mucous or blowing the mucous into a tissue, you are producing more than normal, or more than the normal system can handle.
Excess mucous can be due to a cold (virus), a bacterial infection, allergy, non-allergic causes (see vasomotor rhinitis or non-allergic rhinitis), or a fungal infection. The average child under 12 years of age may suffer from six colds (viral infections) in a year, most of these resolve without the need for an antibiotic.
When we wake up in the morning, most people will have some degree of nasal congestion and some mucous that we clear from our nose and throat. After sitting up and starting the day, the mucous that is produced should be clear and minimal. If the mucous is green or dark yellow and thick after seven days, then you most likely have a bacterial infection. A doctor may prescribe an antibiotic. If the mucous is thick in the morning, but clears during the day then the recently produced mucous is not infected, so no antibiotic is needed.
If you suffer from sinus infections you should seek help from an allergist/immunologist. In our practice we are experts in diagnosing, treating and managing sinus infections. Sinus surgery should never be done unless you have seen an immunologist trained in treating recurrent infections. Every week we see patients that have had sinus surgery and only a little benefit was seen. If your immune system is the problem having the sinus surgery may not be helpful, but addressing the immune system is the key. Please do not have sinus surgery unless you have been evaluated by an allergist immunologist trained in treating recurrent infections.
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