Chronic Sinusitis

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Introduction

Chronic sinusitis is a complication of sinusitis, an uncomfortable condition that occurs when the sinuses cannot drain.  Although the average case of sinusitis may last for several weeks, chronic sinusitis results when it lasts for three months or longer, or recurs following treatment.  Chronic sinusitis is treated with medications, surgery, non-surgical treatments, or a combination of these. 
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Anatomy

Your sinuses are spaces in your skull.  You have four sets of sinuses, for a total of eight.  They are located in the bones behind your forehead, cheeks, nose, and eyes.  The paranasal sinuses are located in the areas around your cheeks, nose, and eyes.
 
Your nose and sinuses are filled with air and lined with mucus membranes.  The mucus membrane helps to moisten air as you breathe and acts as a filtering system.  Small hairs, called cilia, are located on the surface of the mucus membranes.  The cilia move mucus out of the sinuses.  The mucus drains through small openings in your nose (ostia) and is swallowed or removed when you blow your nose.
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Causes

Chronic sinusitis results from a prolonged sinus infection (sinusitis) that lasts for more than three months or a sinus infection that recurs despite treatment.  Sinusitis results when the sinus cannot drain.  Swollen mucus linings, polyps, deviated septum, allergens, fungus, molds, and upper respiratory infections can contribute to sinusitis and lead to chronic sinusitis.
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Symptoms

Chronic sinusitis symptoms are similar to sinusitis symptoms.  Chronic sinusitis can cause nasal congestion, yellow-green nasal discharge, and postnasal drip.  You may have a headache that becomes worse when you lean forward.  Your face may feel tender and painful.  Unlike sinusitis, chronic sinusitis does not cause a fever.  You may develop a sore throat, nausea, or coughing.  Your ears or teeth may hurt.  You may feel generally tired.  The eyes may look puffy, and you may have bad breath.  You may not be able to smell or taste things normally.
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Diagnosis

Your doctor can diagnose chronic sinusitis by reviewing your medical history, completing an examination, and conducting some tests.  Nasal and sinus cultures are used to help identify the cause of infection.  Allergy tests are used to find out what you are allergic to. Magnetic resonance imaging (MRI) scans or computed tomography (CT) scans are imaging tests that show the sinus structures.  A nasal endosopy is a procedure that uses an endoscope to see the inside of your sinuses.  An endoscope is a thin tube with a light and a viewing instrument that is inserted through the nostrils. 
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Treatment

There are several treatments for chronic sinusitis.  Antibiotics may be prescribed for 3 to 12 weeks.  You may also receive corticosteroid, decongestant, and antihistamine medications.  It can help to drink plenty of fluids and use a humidifier in your home. Immunotherapy shots may be an option for people with allergies.
 
Endoscopic sinus surgery may be necessary if chronic sinusitis fails to respond to other treatments.  The surgery uses an endoscope to remove nasal polyps or correct a deviated septum.  Computed tomography (CT) guided sinus surgery is an advanced procedure that uses medical imaging to create a 3D guide that is used with endoscopic surgery.  A non-surgical treatment option is balloon sinuplasty.  Balloon sinuplasty involves inserting a wire and thin tube in the nostril and inflating it to widen the sinus passages.  Endoscopic sinus surgery and balloon sinuplasty may be used together.
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Prevention

You may help prevent chronic sinusitis by treating the symptoms of sinusitis and avoiding allergens and smoke.  You may reduce symptoms of chronic sinusitis by:
• Drinking plenty of fluids
• Using a humidifier in your home
• Applying warm face packs to soothe pain
• Do not bend over, as this increases pressure in your face
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Am I at Risk

You may be at risk for chronic sinusitis if you have a long lasting or recurring sinus infection.  Scientists believe that some people may be more vulnerable than others may be to airborne fungus and molds that contribute to chronic sinusitis.
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Complications

Chronic sinusitis can contribute to asthma flare-ups and brain infections, such as meningitis.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.