Chronic sinusitis is a persistent inflammatory condition of one or more sinuses. It is less common than acute sinusitis, but it seems to be increasingly common in all age groups. Several treatments may be tried. Surgery to improve drainage of the sinuses is an option if other treatments fail, and usually works well.

On this page

• What are sinuses?
• What is sinusitis?
• How is chronic sinusitis?
• What are the symptoms of chronic sinusitis?
• Do I need any tests?
• What are the treatments for chronic sinusitis?
• Are there any complications of chronic sinusitis?
• Also useful resources
• References

What are sinuses?

Sinuses are small air-filled spaces inside, cheeks and forehead. They do a bit of mucus that drains into the nose through small channels.

What is sinusitis?

Sinusitis is an inflammation of the sinuses. Most episodes of sinusitis is caused by an infection. The cheekbones (maxillary) sinuses are most commonly affected.

Acute sinusitis means that the infection develops rapidly (within days) and lasts a short time. Most cases of acute sinusitis lasts a week or so, but it is not unusual for it to last 2-3 weeks (ie, longer than most colds). Sometimes it lasts longer. Sinusitis is said to be acute if it lasts from 4-30 days and subacute lasts for 4-12 weeks. A mild bout of acute sinusitis is common and many people have some degree of sinusitis with a cold. Severe Acute sinusitis is uncommon. Most people only have one or two episodes of acute sinusitis in your life. However, some people have recurrent episodes of acute sinusitis.

See separate leaflet called 'acute sinusitis' for details.

Chronic sinusitis means that sinusitis is persistent and lasts 12 weeks. Chronic sinusitis is uncommon. The rest of this leaflet is only about chronic sinusitis.

How is chronic sinusitis?

Most cases of chronic sinusitis develop after an acute sinus infection. (Most cases of acute sinusitis disappear in 2-3 weeks, often much earlier in some cases the symptoms do not go away and become chronic.). The following are the causes of acute sinusitis, which can progress to chronic sinusitis:

• Diseases cold or flu-like – in most cases, acute sinusitis develops from an illness like the flu or a cold. Colds and flu are caused by viruses that can spread to the sinuses. The viral infection may remain before deleting, causing viral sinusitis. In a small number of cases, the bacteria in adding to an infection that began with a virus. This can cause a sinus infection that may worsen the infection, last longer and can cause more damage or changes in the lining of the womb.
• Dental infections – in some cases, the infection spreads to the maxillary sinus of an infected tooth.
• Other risk factors for sinus infection – in a few people, one or more factors are present that can make your breasts are more prone to infection. Acute sinusitis may be more likely to progress to chronic sinusitis, as there is an underlying problem. Such factors include:
  • Allergic rhinitis (nasal allergy). The allergy can cause inflammation of the tissue in the inner lining of the nose and block the drainage channels of the sinuses. This makes the breasts more susceptible to infection. See separate leaflets called "Hay Fever" and "Rhinitis (persistent) 'allergic rhinitis to discuss in more detail.
  • Other causes of blockage of the drainage channels of the sinuses, and nasal polyps, objects pushed through the nose (especially in children, such as peas or plastic beads), facial injury or surgery and certain birth defects.
  • Asthma.
  • Cystic Fibrosis.
  • A weakened immune system – for example, people with HIV, people undergoing chemotherapy, etc. A weakened immune system makes you more prone to infection. Fungal infections are rare causes of sinusitis and occur most commonly in people with compromised immune systems.
  • Inflammatory disorders such as Wegener's granulomatosis or sarcoidosis.
  • Pregnancy, which makes you more prone to rhinitis (nasal inflammation).
  • Primary ciliary dyskinesia / Kartagener syndrome 's.
  • Rare tumors of the nose.
  • Smokers.
  • Diabetes.
  • Sniffing substances that irritate the lining of the nose (eg, cocaine).
  • Previous injury to the nose or cheeks.

If you develop chronic sinusitis after an acute sinus infection, symptoms may continue to receive even though the infection is gone. (This is why the treatment of chronic sinusitis with a normal course of antibiotics often does not work.) Having been initially triggered by an infection, persistent symptoms may be due to a combination of factors. For example:

• The poor drainage of the affected breast – the drainage channel of the breasts can become totally or partially blocked.
• An accumulation of mucus in the sinus.
• The inflammatory changes in the resulting coating sinus infection.
• An outbreak of infection from time to time as a result of these changes.

Sometimes, an allergy can cause persistent swelling in one breast and swelling or drainage channel blockade.

What are the symptoms of chronic sinusitis?

The most prominent symptom is usually a blocked nose (nasal obstruction). One or more of the following may also occur:

• A runny nose. The download can be green / yellow.
• A decreased sense of smell.
• Pain in the affected breast. However, pain is often a feature of chronic sinusitis (unlike acute sinusitis). In many cases, it's more of a facial fullness or mild discomfort rather than pain.

The severity of symptoms may come and go. They can be worse during an initial acute sinusitis. Here is moderate and not be so serious, leaving a background level of symptoms. (For example, you may just have a runny nose instead of a completely blocked nose and a mild facial unease.) Then you can develop a new episode of acute sinusitis symptoms worsen again. For the diagnosis of chronic sinusitis, the symptoms must have been present for more than 12 weeks.

Other symptoms that sometimes occur include: headache, bad breath, toothache, cough, feeling of pressure or fullness in the ears and tiredness. In children, symptoms may include irritability, snoring, mouth breathing, difficulty eating and nasal speech.

Do I need any tests?

Your doctor can usually diagnose chronic sinusitis based on your symptoms. They may ask questions to determine whether there might be an underlying problem that causes chronic sinusitis. For example, asthma, allergic rhinitis, infection, chronic dental, etc. Your doctor may also examine your nose to check for obvious abnormalities or deviation of the nasal bones and for other problems such as nasal polyps.

If you develop chronic sinusitis is not easily treated by simple measures, your doctor may suggest that you be referred to an ear, nose and throat. The specialist can do several tests to see if there is an underlying cause that makes you more likely to develop sinusitis (mentioned above). For example, a scan of the sinuses or a detailed look into the nasal cavity.

What are the treatments for chronic sinusitis?

Treating any underlying problem

If you have an underlying problem that may have caused or contributed to chronic sinusitis, the treatment of which usually help their symptoms. For example, this can mean the treatment of allergic rhinitis, treatment of an infected tooth, treatment of asthma, treatment of a fungal infection, etc.

Avoiding things that can make your symptoms worse

If you have chronic sinusitis and you are a smoker, you may find that if you quit your symptoms improve. This may be especially the case if you have allergies too. You should also practice good dental hygiene if you are prone to chronic sinusitis, as it can be caused by a dental infection.

Divers with nasal or sinus should be aware of the possible serious consequences of barotrauma sinusitis (sinus damage as a result of differences in pressure when diving). Barotrauma recurring sinus chain can cause complications such as serious infections and damage to the nerves of the face and eyes. If you have had chronic sinusitis and want to dive, you should consult your doctor.

Flying in an airplane can cause increased pain if a channel blockade sinus drainage. This is because, with the change in air pressure in an airplane, no pressure equalizes between the breast and the outside, due to clogging. The pain tends to be worse when the plane is descending to land.

Medical treatments

The class of drugs that can be considered are:

• Steroids applied to the nasal mucosa using aerosols or drops is recommended for all types of chronic sinusitis, and to help reduce inflammation. A long can be recommended, for example for three months. Occasionally, when symptoms are severe, a course of steroid tablets by mouth may be suggested. However, they are more likely to produce side effects. See separate leaflet called 'tablets' steroid for details.
• Prolonged courses of antibiotics (3-4 weeks) are sometimes useful, but they are the most prescribed after a thorough evaluation by an ear, nose and throat.
• Antifungal drugs are needed if you have a fungal infection of the breast (rare).

If you have an outbreak of acute sinusitis symptoms more in the top of the symptoms of his background, one or more of the following may be helpful:

• Analgesics such as acetaminophen or ibuprofen usually relieve any pain. Sometimes stronger analgesics such as codeine, are necessary for a short period of time.
• Nasal sprays or drops are sometimes used. You can buy these at pharmacies. It may briefly relieve a stuffy nose. You should not use a decongestant spray or drops for more than 5-7 days at a time. If used for longer, can cause rebound congestion worse in the nose.
• Facial hot compresses held in the breasts can help relieve pain.
• A saline solution can help relieve nasal congestion and blocked nose.
• A short course of antibiotics can sometimes be advised by your doctor if you suspect a bacterial infection.

Surgical treatments

Surgery is mainly used if the condition does not improve with medical treatment earlier. The principal goal of surgery is to improve draining the affected breast.

The most common operation is called functional endoscopic sinus (FESS). This involves a surgeon inserts an endoscope into the nose. The endoscope used for this procedure is a rigid instrument containing thin lenses. The endoscope allows an enlarged detailed view of inside the nose. The surgeon can see the opening of the drainage channels of the breasts. He or she can remove all of the tissue that block the drainage of the affected breast. This can improve sinus drainage and ventilation and help restore normal function of the breast. This operation is minimally invasive (cause little damage) and usually has a high rate of success in alleviating the symptoms of chronic sinusitis.

A more recent development operation is called balloon dilation catheter sinus ostia. This involves a small balloon surgeon pushes through a hose into the nostril, within command. The balloon is inflated which pushes across the blocked area. The balloon is deflated and removed. After this procedure is a good chance that the drainage canal is enlarged breasts and breast can drain properly. There's a press release with a video showing this procedure is performed on the BBC website: http://news.bbc.co.uk/1/hi/health/8103949.stm

Surgery can sometimes be necessary to remove nasal polyps or correct problems with bones inside the nose diverted.

Are there any complications of chronic sinusitis?

Living with untreated chronic sinusitis can be nasty with persistent symptoms but serious complications are rare. In rare cases, a sinus infection can spread to nearby areas such as around the eyes, in the adjacent bones, blood or brain. Children are more prone to complications than adults. The swelling or redness of the eyelids or cheek of a child with sinusitis should be reported to a doctor urgently.

Also useful resources

Balloon Sinuplasty

Web: www.balloonsinuplasty.co.uk
A website with all the details about chronic sinusitis Balloon Sinuplasty – a treatment option for chronic sinusitis.