Diagnosing acute sinus problems can be challenging as it is not always clear if infection (bacterial) is present or if the common cold (viral) is to blame. This is why you should first see your family doctor. Then, your primary care physician can recommend you to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist) if s/he suspects that you may be experiencing sinusitis. Referral to an ENT specialist may be beneficial for people who have suspected nasal polyps or other conditions causing blockage of the nasal cavity. Additionally, this type of specialist can provide a more specialized examination of the nasal passages and upper throat.
An infectious disease specialist may be needed when sinusitis is caused by something unusual or when rare complications (such as an infection of the facial bones) occur. An allergist may be needed when allergies are suspected to be causing or contributing to sinus problems.
Your doctor can usually diagnose acute sinusitis by noting symptoms and doing a physical examination, which includes examining your nasal tissues. A detailed history of the problem, however, can be of more value to the diagnosis than a physical exam. If the symptoms and physical findings are typically consistent of sinusitis, further testing is usually not needed.
A doctor will usually diagnose sinusitis based on reported symptoms and observed symptoms upon examination as well as medical history and physical examination. Additional tests may be ordered and performed if:
Imaging tests - Imaging tests may be used when symptoms of sinusitis persist or recur despite treatment. They are also useful when there is a need to look for tumors or other growths or if there is reason to believe that an infection has spread beyond the sinuses. Additionally, imaging tests are very helpful when there is bleeding or bloody discharge from the nose. Imaging tests include:
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
Laboratory tests - Your doctor may also use a variety of test to diagnose chronic sinusitis or rule out other conditions (such as cystic fibrosis or an immune deficiency disorder) or to identify the cause of infection. A biopsy of the lining(s) of the nose or sinuses can also help evaluate the health of the sinuses. These tests include:
- bacterial tests
- blood tests
- nasal culture
- sweat tests
Medical procedures - Other procedures that may be performed to confirm diagnosis. These procedures may include:
- an endoscopic sinus exam (ESM) (nasal endoscopy)
- a needle puncture and aspiration of sinus contents
Once a diagnosis of sinusitis is made, a person can begin treatment. Treatment of sinusitis focuses on eliminating or managing the condition until its cause is identified and the symptoms are eliminated. To learn about the most common forms of sinusitis treatment, read on.
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