Physical Examination for Sinusitis

During a physical examination for sinusitis, your doctor inspects the ears, nose, and throat and checks for any evidence of nasal blockage. The visible part of the mucous membrane that lines the nose and sinuses is observed for swelling and redness. The doctor may press on the person's face over the sinuses to locate swollen or tender areas.

The location and intensity of pain or pressure may help your doctor identify which sinuses are involved:

• Pain over the bridge of the nose may mean an infection in the ethmoid sinuses.
• Deep pain behind the eyes or headache in the back of the head may mean an infection in the sphenoidal sinuses.
• Pain above the eyebrow in the morning that gets worse when bending over may mean an infection in the frontal sinuses.
• Pain or pressure in the cheeks may mean an infection in the maxillary sinuses.

See a picture of the location of the facial sinuses.

If your doctor can look in the nostril and see thick, discolored mucus coming out of a sinus opening, this strongly suggests that sinusitis is present. If the symptoms and physical findings are typical of acute sinusitis, generally no further examinations or tests are needed to make the diagnosis.

Transillumination is a technique that can sometimes be used in adults to see whether a sinus is completely filled with mucus. During this procedure, the doctor will shine a very bright light into the mouth. If a maxillary or frontal sinus on one side is completely dark compared to the sinus on the other side, sinusitis may be present. This test is not very reliable.

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