Description

Chronic sinusitis causes the spaces inside your nose and head, called sinuses, which are inflamed and swollen. The condition lasts 12 weeks or longer, even with treatment.

This is a common condition that keeps the mucus drainage. This causes a stuffy nose. Breathing through the nose can be difficult. The area around your eyes might feel swollen or tender.

Infection, tumors in the breast, called nasal polyps, and the inflammation of the lining of the sinuses may be part of the chronic sinusitis. Chronic sinusitis is also called chronic rhinosinusitis. The condition affects both adults and children.

Symptoms

The common symptoms of chronic sinusitis are:

  • Thick, discolored mucus from the nose, known as a runny nose.
  • The mucus toward the back of the throat, known as postnasal drip.
  • Blocked or stuffy nose, known as congestion. This makes it difficult to breathe through the nose.
  • Pain, tenderness and swelling around the eyes, cheeks, nose or forehead.
  • Reduction of the sense of smell and taste.

Other symptoms may include:

  • The ear pain.
  • The pain of a headache.
  • Pain in the teeth.
  • For cough.
  • The sore throat.
  • The bad breath.
  • Fatigue.

Chronic sinusitis and acute sinusitis have similar symptoms. But acute sinusitis is a short-term infection of the sinuses often linked to a cold.

The symptoms of chronic sinusitis last for at least 12 weeks. There could be many episodes of acute sinusitis before it becomes chronic sinusitis. The fever is not common with chronic sinusitis. But the fever may be part of the acute sinusitis.

When to see a doctor

Schedule an appointment with your health care provider for:

  • Repeated sinusitis, and if the condition does not improve with treatment.
  • The symptoms of Sinusitis that lasts more than 10 days.

See a health care provider right away if you have symptoms that could mean a serious infection:

  • Fever.
  • Swelling or redness around the eyes.
  • Strong headache.
  • In front of the swelling.
  • Confusion.
  • Double vision, or other vision changes.
  • Stiffness in the neck.

Causes

The cause of chronic sinusitis is not generally known. Some medical conditions, including cystic fibrosis, can cause chronic sinusitis in children and adolescents.

Some conditions that can cause chronic sinusitis worse. These include:

  • A cold or other infection that affects the sinuses. The virus or bacteria that can cause these infections.
  • A problem on the inside of the nose such as a deviated nasal septum, nasal polyps or tumors.

Risk factors

The following factors increase your risk of getting chronic sinusitis:

  • A dental infection.
  • A fungal infection.
  • Regular, being around cigarette smoke or other pollutants.

Complications

Serious complications of chronic sinusitis are rare. These may include:

  • Vision problems. If a sinus infection is spread to an eye socket, it can reduce vision or, possibly, because of the blindness.
  • Infections. It is not common. But a serious infection of the sinuses can spread to the membranes and fluid that surrounds the brain and the spinal cord. The infection is called meningitis. Other serious infections that can spread to the bone, called osteomyelitis, or in the skin called cellulitis.

Prevention

Follow these steps to reduce the risk of contracting chronic sinusitis:

  • Protect your health. Try to stay away from people who have colds or other infections. Wash your hands often with soap and water, especially before meals.
  • Control allergies. Work with your health care provider to keep the symptoms under control. Stay away from the things that you are allergic when possible.
  • Avoid cigarette smoke and air pollution. Tobacco smoke and other pollutants can irritate the lungs and the inside of the nose, called the nasal passages.
  • The use of a humidifier. If the air is dry, add moisture to the air with a humidifier can help prevent sinusitis. Make sure that the humidifier is kept clean and free of rust with regular, thorough cleaning.

Diagnosis

A health care provider will ask about your symptoms and do an exam. The exam may include pain sensation in the nose and face and looking on the inside of the nose.

Other ways to diagnose chronic sinusitis and to rule out other conditions include:

  • Nasal Endoscopy. A doctor inserts a thin, flexible tube called an endoscope, in the nose. A light in the tube allows a health care provider see the inside of the sinuses.
  • Imaging tests. Ct or mri can show details of your sinuses and nasal area. These images may point to the cause of chronic sinusitis.
  • Nasal and sinuses of the samples. The lab tests are not often used for the diagnosis of chronic sinusitis. But, if the condition does not improve with treatment or worsen, tissue samples from the nose or sinuses can help find the cause.
  • An allergy test. If allergies may be the cause of chronic sinusitis, an allergy skin test can show the cause.

Treatment

Treatments for chronic sinusitis are:

  • The nasal corticosteroids. These nasal sprays help prevent and treat the inflammation. Some are available without a prescription. Examples include fluticasone (Flonase Allergy Relief, Xhance), budesonide (Rhinocort Allergy), mometasone (Nasonex 24-hour Allergy), and beclomethasone (Beconase AQ, Qnasl, other).
  • Nasal saline rinses. The use of a specially designed squeeze bottle (NeilMed Sinus Rinse, others) or neti pot. This home remedy, called a nasal wash can help clear the sinuses. Saline nasal sprays are also available.
  • Corticosteroids injections or pills. These medications ease severe sinusitis, especially for those who have nasal polyps. Injections and pills can cause serious side effects when used long term. So they're used only to treat severe symptoms.
  • Allergy medications. The use of allergy medications may decrease allergy symptoms of sinusitis caused by allergies.
  • Aspirin desensitization treatment. This is for people who react to aspirin and the reaction of the causes of sinusitis and nasal polyps. Under medical supervision, people receiving higher doses of aspirin to increase your ability to make.
  • Medicine for the treatment of nasal polyps and chronic sinusitis. If you have nasal polyps and chronic sinusitis, a shot of dupilumab (Dupixent), omalizumab (Xolair) or mepolizumab (Nucala) could reduce the size of nasal polyps and decrease congestion.

Antibiotics

Antibiotics are sometimes necessary for the treatment of sinusitis caused by bacteria. A possible bacterial infection may need to be treated with an antibiotic, and sometimes with other medications.

Immunotherapy

For sinusitis caused or aggravated by allergies, allergy shots can help. This is known as immunotherapy.

Surgery

For chronic sinusitis that does not improve with treatment, endoscopic sinus surgery may be an option. In this procedure, a doctor uses a thin, flexible tube with a light attached, called an endoscope, and small cutting tools to remove the tissue that is causing the problem.

Lifestyle and home remedies

These self-help steps can help relieve the symptoms of sinusitis:

  • Rest. The rest helps the body fight infection and speed up recovery.
  • Drink fluids. Drink plenty of fluids.
  • The use of a warm compress. A hot compress on the nose and forehead can help alleviate the pressure in the sinuses.
  • Keep the sinuses moist. Put a towel over your head while breathing in the steam from a bowl of hot water. Or take a hot shower, breathing in the air hot and humid. This will help ease the pain and help mucus drain.

Preparing for your appointment

It is likely that you see your primary care provider for symptoms of sinusitis. If you have had many episodes of acute sinusitis or have symptoms of chronic sinusitis, your doctor may refer you to an allergy specialist or an ear, nose, and throat specialist.

Here is the information to help you prepare for your appointment.

What you can do

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason of his appointment, and when they began.
  • Key personal information, including if you have allergies or asthma, and the medical history of the family.
  • All the medications, vitamins, or other supplements that you take, including over-dose.
  • Questions to ask your health care provider.

For chronic sinusitis, questions to ask your provider include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • Is my condition likely to disappear or to be of long duration?
  • What treatment do you suggest for me?
  • I have these other health conditions. How can I best manage these conditions?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your care provider will likely ask you questions, such as:

  • Do you have symptoms all the time or sometimes?
  • How bad are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you smoke or are around smoke or other pollutants?
Symptoms and treatment of Chronic sinusitis