Sinusitis in older adults

Overview

Sinusitis is swelling of the lining of your sinuses — the small, air-filled spaces behind your forehead, cheeks, and eyes. This swelling blocks the normal drainage of mucus and can cause pain and pressure. In older adults, it often follows a cold or allergies.

Yes, sinusitis is a common condition in people of all ages, including older adults.

Sinusitis affects older adults, especially those with a weakened immune system, allergies, nasal polyps (small growths in the nose), or a deviated septum (crooked wall inside the nose).

Symptoms

Common symptoms

• Stuffy or runny nose
• Pain or pressure in the face (around the cheeks, eyes, or forehead)
• Headache
• Postnasal drip (mucus dripping down the back of the throat)
• Cough
• Reduced sense of smell
• Bad breath

Symptoms in children

• In children, symptoms also include irritability, difficulty feeding, and ear pain.

Symptoms in older adults

• Less fever or no fever
• Feeling very tired or weak
• Confusion or trouble thinking clearly
• Reduced appetite
• Cough that does not go away

Causes

Main causes

• Viral infections (like the common cold)
• Bacterial infections (less common, often after a long viral sinusitis)
• Fungal infections (rare, but more likely in older adults with weak immune systems)
• Allergies (hay fever or year-round allergies)
• Swelling from nasal polyps or a deviated septum

Risk factors

• Weakened immune system (from illness or medications)
• Nasal polyps or structural problems in the nose
• Allergies or asthma
• Smoking or exposure to second-hand smoke
• Dry air or air pollution
• Dental infection in the upper teeth

When to see a doctor

See a doctor urgently if:

• You have symptoms that get worse after the first week
• You have a fever higher than 38°C (100.4°F)
• You have severe face pain or swelling
• You have vision changes, double vision, or redness around the eye

Book a routine appointment if:

• Your symptoms last more than 10 days
• You have had several sinus infections in the past year
• Your sense of smell does not come back after the infection
• You have a cough that will not go away

Diagnosis

Your doctor will ask about your symptoms and look inside your nose with a small lighted tool. They may also press on your face to check for tenderness.

Tests that may be done

• Nasal endoscopy (a thin tube with a camera to see inside your sinuses)
• Imaging tests like a CT scan (if symptoms are severe or keep coming back)
• A sample of your mucus to check for bacteria or fungus (rare)

What to expect at your appointment

The doctor will explain your condition and talk about treatment options. Most of the time, no special tests are needed. The diagnosis is based on your symptoms and exam.

Treatment

Treatment depends on whether the sinusitis is caused by a virus or bacteria, how long you have had it, and your overall health. Many cases get better with simple home care.

Self-care at home

• Rest and drink plenty of fluids (water, tea, clear soup)
• Use a humidifier or breathe in steam from a bowl of hot water (carefully) to moisten nasal passages
• Apply warm compresses to your face to ease pain
• Use saline (salt water) nasal sprays or rinses to keep your nose moist
• Elevate your head with an extra pillow when sleeping

Medical treatments

Your doctor may suggest over-the-counter pain relievers, decongestants (used only for a few days), or nasal spray medications to reduce swelling. If a bacterial infection is likely, a short course of antibiotics may be prescribed. Always follow your doctor’s instructions carefully.

When is surgery considered?

Surgery is rarely needed. It may be considered if you have nasal polyps, a deviated septum, or long-term (chronic) sinusitis that does not get better with medicine. The procedure is usually done through the nose (endoscopic sinus surgery).

Living with this condition

Sinusitis can be uncomfortable, but most people recover fully. You can manage symptoms with self-care and stay in touch with your doctor if things do not improve.

Lifestyle tips

• Avoid smoking and second-hand smoke
• Stay away from known allergy triggers (dust, pollen, pet dander)
• Wash your hands often to prevent colds
• Get plenty of rest and manage stress

Diet and exercise

Eat a balanced diet with fruits and vegetables to support your immune system. Gentle exercise, like walking, can help you feel better once symptoms start to improve, but rest is more important when you are unwell.

Mental health and emotional wellbeing

Feeling unwell for a long time can make you feel down or frustrated. It is normal to feel this way. Talk to your doctor if you notice sadness or anxiety that does not go away.

Prevention

You can reduce your chances of getting sinusitis by avoiding colds and flu, treating allergies, and keeping your nasal passages moist. Avoiding smoke and irritants also helps.

Vaccines

Getting the flu vaccine every year and the pneumococcal vaccine (as recommended by your doctor) can help prevent infections that might lead to sinusitis.

Screening programmes

There is no routine screening for sinusitis. If you have health problems that increase your risk, your doctor may talk to you about prevention strategies.

Complications

If left untreated

• Spread of infection to the bones around the eye (orbital cellulitis) - rare but serious
• Brain abscess or meningitis (infection of the covering of the brain) - very rare
• Chronic sinusitis (symptoms lasting 12 weeks or more)

Long-term outlook

The outlook for sinusitis in older adults is very good. Most people recover completely with simple home care or a short course of medicine. If you have chronic sinusitis, treatments can help you manage symptoms and improve your quality of life. Always talk to your doctor to find the best plan for you.

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