Chronic Sinusitis

Chronic sinusitis is a common, yet serious, condition. It affects over 30 million Americans every year, disrupting quality of life. 

What is chronic sinusitis? 

Chronic sinusitis is sinusitis that lasts for three months or more. You may also have nasal polyps. 

Chronic sinusitis with nasal polyps is a more severe form of the condition, characterized by grape-like swellings in the sinus tissue lining. Severe underlying inflammation causes polyps. People with nasal polyps usually need one or more surgeries to treat the condition.

Chronic sinusitis symptoms

Chronic sinusitis is a persistent condition, with symptoms that include:

• Nasal obstruction that blocks airflow in one or both of your nostrils 
• Thick and/or foul-smelling or tasting nasal discharge or postnasal drip
• Loss of smell

Nasal obstruction and decreased smell are more severe if you have chronic sinusitis with polyps. You may also experience the following symptoms, although they are more frequent in acute sinusitis:

• Fever
• Facial pain or pressure in the cheeks, forehead, bridge of your nose, top of your head or behind your eyes (often called a sinus headache)

Nonsurgical treatment for chronic sinusitis 

Your ENT doctor will recommend treatment options based on the severity and cause of your chronic sinusitis symptoms. Treatment options may include:

• High-volume saline irrigations flush the nose and sinuses of excess mucus. We recommend saline solutions for use two to three times per day until symptoms subside.
• Nasal steroid sprays reduce inflammation in the nose. These are available by prescription or over the counter.
• Oral steroid taper (prednisone or Medrol®) relieves symptoms within one to two weeks. A taper means that the dosage is decreased over the course of treatment.
• Antibiotics may be prescribed for up to three weeks if a bacterial infection is present.
• Decongestants help by constricting blood vessels in the sinus and nasal tissues, shrinking the swollen tissues and making it easier to breathe. 
• Expectorants include medications such as guaifenesin (e.g., Mucinex®), which thin the mucus. This makes it easier to cough up the mucus or blow it out your nose. 

Chronic sinusitis surgery

We may recommend endoscopic sinus surgery if you have chronic sinusitis. Surgery enlarges the natural openings of the sinuses to allow for better distribution of saline, nasal sprays and other sinus medications. Wider openings also make it easier for the sinuses to drain, even when swollen.