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These flare ups may be partly due to mucus dripping into the throat and windpipe, causing cough and irritation. Infection from the sinuses may also be carried into the lower bronchial tree, triggering inflammation and asthma. This may often occur at night, another reason for night time asthma attacks. Nasal and sinus congestion may also produce obstruction of these passages, necessitating mouth breathing, and the absence of warming and moisturizing of inhaled air that the nasal and sinus passages produce may also exacerbate bronchial asthma. How Is Sinusitis Diagnosed ?The characteristic symptoms of sinus disease include nasal congestion, pain, and a discolored mucus discharge. The pain usually occurs over or near the affected sinus. Often, this pain is felt as a severe headache, particularly over the forehead. Facial swelling is also common and so is tenderness over the affected areas. Examination is usually done with a flashlight that looks into the nasal passages, often aided by an instrument called a nasal speculum that widens the doctor’s field of view into the nose. For a more detailed examination with the ability to better visualize the sinus openings, fiberoptic instruments such as the flexible endoscope may be used. A sinusitis diagnosis may be confirmed by x-ray. Plain sinus films may demonstrate the presence of fluid in the sinus cavities or a thickening of the lining. The more highly detailed CAT scan (computerized axial tomography) is now widely used to diagnose sinusitis because it may pick up disease plain x-ray films miss.

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