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Chronic Sinusitis

Chronic sinusitis causes mucus accumulation and inflamed nasal passages.

What is Sinusitis?

Sinusitis occurs when the cavities around the nasal passages (the sinuses) become inflamed and swollen. This interferes with drainage and causes mucus to build up in the nose and sinuses.

Causes of Chronic Sinusitis

There are different causes of sinusitis.

• Viruses are the most common cause of sinusitis; infections caused by viruses are usually easily treatable

• Bacterial sinusitis symptoms usually last longer and respond to oral antibiotics

• Fungal sinusitis is rarer and usually occurs in people with a weakened immune system; certain pre-existing conditions may increase the risk of fungal sinusitis occurring

Chronic Sinusitis Complications

Occasionally, untreated sinusitis may spread, leading to complications which include meningitis, eye infections and the worsening of pre-existing asthma.

When medications fail, chronic sinus congestion occurs and needs treatment.

Sinusitis Symptoms

Symptoms of sinusitis include:

• Difficulty breathing through the nose

• Fever

• Pain around the sinus area

• A heavy feeling in the head and face

• A thick yellow or green discharge from the nose; mucus may travel down the back of the throat leading to a cough

• An aching jaw, teeth or ears

• Partial loss of smell and taste

• Bad breath

• Nausea

• Tiredness

Diagnosis of Sinusitis

A nasoendoscopic examination — involving a small camera with a tube being inserted into the nose to view the nasal passages — may be performed to reach the drainage pathways of the sinuses. This may be uncomfortable but is not painful. The examination will also reveal the presence of any pus-like discharge.

In cases of persistent sinusitis, a sample of the discharge may be taken to identify the bacteria causing it, and help to determine which antibiotics are needed.

A computed tomographic scan (CT scan) may also be carried out to show any anatomical problems that are causing recurrent or chronic sinusitis infection.

Chronic Sinusitis Treatment

In chronic sinusitis, the obstruction may not be completely cured by medications and a type of surgery known as functional endoscopic sinus surgery (FESS) may be necessary.

Most sinus surgeries are performed through the nose with the aid of scopes and other instruments that enable treatment of the chronic sinus congestion without causing facial scars.

This article was last reviewed on Wednesday, November 22, 2023