Chronic Sinusitis

Chronic sinusitis is a long-term swelling or infection of the sinuses. If sinusitis lasts more than 12 weeks (90 days), it is called chronic.

Front view of sinuses showing pale, swollen mucosa and mucus buildup.

What is chronic sinusitis?

Sinuses are air-filled spaces in the skull behind the face. They are kept moist and clean by a lining of mucosa. Things such as pollen, smoke, and chemical fumes can bother the mucosa. Constant exposure to irritants can cause ongoing swelling of this lining. It can also harm tiny hairlike cilia that cover the mucosa. Cilia help carry mucus toward the opening of the sinus. Damage to cilia keeps mucus from draining from the sinuses.

Causes of chronic sinusitis

Problems that irritate the mucosa or block drainage can lead to chronic sinusitis. These may include:

  • Infections

  • Chronic allergies

  • Nasal polyps, deviated septum, or other blockages

  • Ongoing exposure to irritants, such as cigarette smoke or fumes

  • Asthma

  • Acute sinusitis that keeps coming back

Common symptoms of chronic sinusitis

Symptoms may include:

  • Facial pain and pressure

  • Headache and sinus pain

  • Nasal congestion

  • Thick, colored drainage from the nose

  • Thick mucus draining down the back of the throat (postnasal drainage)

  • Loss of smell

  • Fever

  • Cough

  • Sore throat

Diagnosing chronic sinusitis

Your healthcare provider will ask about your symptoms and past health. He or she will look at your nose and face. You may have imaging studies such as an X-ray or CT scan of the sinuses. Your healthcare provider may also take a sample of the drainage to check for bacteria. You may also have an endoscopy. During this test, the healthcare provider puts a lighted tube up your nose to look at your sinuses.

Treating chronic sinusitis

The goal of treatment is to reduce irritation and swelling. Your plan may involve:

  • Taking medicines. Your healthcare provider may give you medicines to reduce the amount of mucus and swelling. These help unblock the sinuses and let them drain. You will need to take antibiotics if you have a bacterial infection.

  • Flushing your sinuses. Your healthcare provider may suggest sinus irrigation. This is flushing your sinuses with saltwater or saline solution. This helps to clear out mucus.

  • Controlling allergies. If you have allergies, you should have a plan to help control them. You may need to take medicines or get allergy shots.

  • Controlling nasal irritants. If you smoke, ask your healthcare provider for help to stop.

  • Having surgery. In some cases, you may need surgery on the nose, sinuses, or both. This can improve sinus drainage or remove nasal blockages.