Chronic Sinusitis

What is chronic sinusitis?

Chronic sinusitis is long-lasting swelling or infection in your sinuses. Unlike acute sinusitis, which typically goes away within 10 days, chronic sinusitis may last 12 weeks or more. Healthcare providers can help cure it, but you may need several different kinds of treatment to make it go away for good.

What are chronic sinusitis symptoms?

If you have chronic sinusitis, you may feel:

• Tenderness or pressure, particularly around your nose, eyes and forehead.
• Thick yellow or green mucus from your nose or postnasal drip (mucus that builds up and drips down the back of your throat).
• Stuffy nose.
• Toothache.
• Headache, particularly a headache that makes your face hurt.
• Cough.
• Tiredness.
• Ear pain.
• Loss of the senses of taste (ageusia) and smell (anosmia).
• Bad breath (halitosis).

What causes chronic sinusitis?

Your sinuses are a series of connected hollow spaces behind your cheekbones, forehead and nose. Air that comes in through your nose moves through your sinuses on its way to your lungs.

Your sinuses are lined with tissue. They also make mucus that keeps the inside of your nose moist and takes care of debris that air might move into your nose, like bacteria, viruses and dust-carrying allergens. In chronic sinusitis, your sinus tissues swell, sometimes trapping mucus so it can’t flow from your nose as it should. (You have several sinuses, and swelling may affect one or more of them.)

Chronic sinusitis may happen because you have:

• Conditions that block your airways, like asthma, allergies or cystic fibrosis.
• Tooth infection.
• Weak immune system, which makes you more vulnerable to infections that cause chronic sinusitis.
• Polyps (growths) in your nose.

What are the risk factors for chronic sinusitis?

If you have asthma or allergies, you’re more likely to develop chronic sinusitis because your airways are more likely to become inflamed or irritated, making your sinus tissue swell.

What are the complications of this condition?

Untreated chronic sinusitis may cause infections that spread from your sinuses into your eyes, bones, brain or spine.

How is chronic sinusitis diagnosed?

If sinus infection symptoms last 12 weeks or more, healthcare providers may determine that you have chronic sinusitis. They may do the following tests:

• Examine the inside of your nose with an endoscope, a tool that lets them look inside your nose and sinuses. They may also remove tissue that medical pathologists examine under a microscope.
• CT scan or MRI to look for polyps or see if you have a deviated septum.
• Biopsy, in case your provider suspects your issue is caused by something other than chronic sinusitis or acute fungal infection. Providers rarely do biopsies to diagnose chronic sinusitis.

What’s the treatment for chronic sinusitis?

Chronic sinusitis treatment focuses on controlling or easing inflammation. That’s because most chronic sinusitis happens when something irritates your sinuses. But treatments may vary depending on your situation. Your provider may prescribe:

• Nasal saline irrigation.
• Nasal steroid sprays.
• Surgery to fix a deviated septum, remove nasal polyps, open up your sinuses or remove fungal balls (clumps of fungal infection that block sinuses.
• Balloon sinuplasty, a procedure that opens your sinus cavities.

Can chronic sinusitis be prevented?

You may be able to prevent infections and chronic sinusitis if you:

• Get treatment for conditions that may cause chronic sinusitis, like asthma and allergies.
• Avoid allergens such as animal dander, dust, pollen, smoke and mold that make your sinuses swell.
• If you smoke, try to stop. If you don’t smoke, avoid secondhand smoke.
• Avoid infections by washing your hands thoroughly with soap and water.
• Rinse your nasal passages with saline solution, either purchased or with a neti pot.
• Use a humidifier to keep nasal tissues moist.

Can chronic sinusitis be cured?

Yes, it can, depending on the cause. For example, if nasal polyps cause chronic sinusitis, removing the polyps could cure the condition.

When should I see my healthcare provider?

If you’ve had sinusitis symptoms for weeks, it’s time to contact a healthcare provider. Sinusitis symptoms include thick green or yellow mucus from your nose, or it hurts when you put gentle pressure on your nose, forehead or around your eyes.

Is there anything I can do at home to feel better?

• Take a shower. The warm steam may help ease sinus pressure. Don’t have time for a shower? Wring out a washcloth soaked in warm water and drape it over your face.
• Drink up. Drinking water and clear liquids may help thin the mucus clogging your nose.
• Get extra rest. Chronic sinusitis can affect your sleep. If you can, build a nap into your daily schedule. If an infection is the chronic sinusitis cause, extra rest may help you recover.

What questions should I ask my healthcare provider?

You may want to ask the following questions:

• What’s causing my chronic sinusitis?
• What treatment do you recommend?
• Will treatment cure my condition?

What’s the difference between chronic sinusitis and recurrent sinusitis?

Chronic sinusitis is different from recurrent sinusitis because chronic sinusitis symptoms don’t go away for long periods of time. In recurrent sinusitis, you have four or more bouts of sinusitis in one year, but you also have symptom-free periods in between.

A note from Cleveland Clinic

Chronis sinusitis isn’t a serious illness, but it can make you feel miserable. You may feel like you’re dragging yourself through your daily activities and exhausted because symptoms affect your sleep. You may have done your best to cope, but it’s been weeks of feeling congested, coughing and generally run down. If that’s your situation, don’t hesitate to contact a healthcare provider. They’ll find out what caused your chronic sinusitis and recommend treatment. They’ll also recommend steps you can take to ease your symptoms while you recover.