What is chronic sinusitis?
Sinuses are hollow spaces in the skull. Chronic sinusitis occurs when the tissue lining the facial sinuses becomes inflamed for at least three months. Chronic sinusitis usually involves nasal airway swelling (rhinitis). Hence, it is also called chronic rhinosinusitis (CRS). Chronic sinusitis usually occurs as a result of repeated episodes of acute sinusitis that have not been managed appropriately. CRS is typically noninfective and occurs mainly due to allergies or medical conditions such as cystic fibrosis (a disease where the clearing of secretions by the nose and lungs is impaired). In CRS, normal drainage of secretions by the facial sinuses is impaired and there is inflammation and swelling of the tissues in the nose and sinuses causing nasal discharge and obstruction. CRS can affect both adults and children.
CRS is classified into three main categories
- CRS without polyps: Polyps are abnormal tissue growths arising from mucosal linings.
- CRS with polyps
- Allergic fungal rhinosinusitis (AFRS): Occurs due to allergic reactions of the nose and sinuses to fungal spores.
What causes chronic sinusitis?
The causes of chronic sinusitis include the following
- Nasal polyps: Polyps are small growths of the nasal lining that can cause obstruction of the ostium (sinus opening) preventing normal drainage and clearance of mucus out of the sinuses. They also obstruct the nasal passages.
- Deviated nasal septum (DNS): The nasal septum divides the nose into two regions, the right and left nasal cavities. If the nasal septum is bent (deviated), it causes narrowing of the nasal airway and may obstruct the sinus opening. DNS can also worsen symptoms of chronic rhinosinusitis (CRS).
- Systemic medical conditions: CRS can occur as a result of diseases such as cystic fibrosis where mucus clearance is impaired, human immunodeficiency virus (HIV), and other inflammatory and immune system-related diseases.
- Recurrent respiratory tract infections: Recurrent infections (viral, bacterial, or fungal) in the upper and lower respiratory tract can cause chronic inflammation of the lining of the nose and sinuses leading to CRS.
- Allergy: Inflammatory responses to allergens in the environment can cause chronic inflammation of the nose and sinuses.
What are the risk factors for chronic sinusitis?
The risk of chronic sinusitis increases due to the following
- Deviated nasal septum (DNS)
- Nasal polyps
- Aspirin sensitivity
- Poor dental hygiene and dental infections
- Immune system–related diseases such as human immunodeficiency virus/acquired immunodeficiency virus (HIV/AIDS)
- Cystic fibrosis
- Hay fever or other allergies
- Chronic exposure to pollutants such as cigarette smoke or industrial gases
What are the signs and symptoms of chronic sinusitis?
Common signs and symptoms of chronic sinusitis include the following
- Nasal inflammation
- Nasal itching
- Thick white or yellowish-white (yellowish discharge indicates superimposed bacterial infection) discharge from the nose
- Postnasal drip (constant drainage of the mucus through the back of the nose and down the throat) causing discomfort and throat irritation
- Nasal obstruction (nose block) or congestion
- Difficulty breathing through the nose
- Pain, tenderness, and swelling around your eyes, cheeks, nose, or forehead
- Reduced sense of smell and taste
- Voice changes
- Ear pain (mainly due to blockage of the eustachian tube causing negative pressure in the ear)
- Pain in the upper jaw and teeth, especially around the canines
- Recurrent throat clearing
- Recurrent episodes of sore throat due to mouth breathing as a result of nasal blockage and postnasal drip
- Halitosis (bad breath)
- Disturbed sleep
- Inability to concentrate
How is chronic sinusitis treated?
Treatment options for chronic sinusitis include the following
- Corticosteroids: Corticosteroids may be prescribed in the form of local nasal sprays, oral medications or as injections. Steroids help to suppress allergy, reduce inflammation and shrink tissue growth. Steroid sprays work locally in the nose and sinuses to reduce inflammation and open the nasal passages. Examples include fluticasone, mometasone and beclomethasone. Oral medications and injections are used to treat more severe cases, those who do not show improvement with sprays and those who have extensive nasal polyps.
- Saline nasal irrigation: The nose may be irrigated with nasal sprays or solutions. This helps to clear the airway by flushing out mucus, crusts and pollutants.
- Aspirin desensitization treatment: Those who have negative reactions to aspirin causing sinusitis can be treated by administering gradually increasing doses of aspirin under a doctor’s supervision until aspirin tolerance increases.
- Antibiotics: Chronic rhinosinusitis (CRS) does not typically cause infections. However, antibiotics are required to treat secondary bacterial infections.
- Immunotherapy: CRS occurring due to long-standing allergies can be treated with immunotherapy. This can help suppress the body's immune cells to reduce reactions to specific allergens. This can help prevent recurrence as well.
- Surgery: Endoscopic sinus surgery may be performed in cases resistant to medical treatment or medication. An endoscope (a thin tube with a light and camera attached) and surgical instruments are inserted into the nose to perform surgery under anesthesia.
Latest Allergies News
Daily Health News
Health Solutions From Our Sponsors
Top Causes Chronic Sinusitis Related Articles
Nasal DecongestantsNasal decongestants are used to treat nasal congestion and discomfort from allergies and colds. There are two types of nasal decongestants; 1) short acting, for example, levmetamfetamine or L-desoxyephedrine (Vicks Vapo Inhaler) and phenylephrine (Neo-Synephrine, Little Noses Decongestant Nose Drops, 4-Way Fast Acting); and 2) long acting, for example xylometazoline (Triaminic Decongestant Spray Nasal & Sinus Congestion) and oxymetazoline (Afrin, Vicks Sinex, Zicam Nasal Gel). Side effects, drug interactions, storage, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
budesonide nasal inhaler (Rhinocort Allergy, Rhinocort Aqua)Budesonide nasal inhaler or spray (Rhinocort Allergy, Rhinocort Aqua) is a medication prescribed for the management of the symptoms of allergic rhinitis and the treatment and prevention of nasal polyps. Review side effects, drug interactions, dosage, and pregnancy and breastfeeding safety information prior to using this drug.
Chronic Rhinitis and Post-Nasal DripChronic rhinitis and post-nasal drip symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) usually is caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year-round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependent upon the type of rhinitis condition.
decongestant drops - nasal
decongestant spray - nasal
fluticasone (Flonase, Flonase Allergy Relief)Fluticasone propionate nasal spray (Flonase, Flonase Allergy Relief) is a corticosteroid prescribed for the management of symptoms of seasonal or perennial allergic and non-allergic rhinitis. Side effects, drug interactions, dosage, safety during pregnancy, and safety in children should be reviewed prior to taking this medication.
fluticasone furoate nasal spray (Veramyst)Fluticasone furoate nasal spray (Veramyst) is a nasal spray prescribed for the treatment of symptoms of seasonal or perennial allergic and non-allergic rhinitis. Side effects, drug interactions, dosage, safety during pregnancy, and safety in children should be reviewed prior to taking this medication.
How Can You Tell if You Have a Sinus Infection?Sinus infection is a common issue that affects many people. Learn the signs of sinus infection, what causes sinus infection, how doctors diagnose sinus infection, and what you can do to treat sinus infection.
How Do You Know if You Have a Sinus Infection (Sinusitis) or COVID-19 Coronavirus?Learn how the signs and symptoms of a sinus infection are different from those caused by COVID-19.
How to Get Rid of a Sinus Infection FastThe sinuses are air-filled cavities that surround the nose and drain into the nose. They are present in the forehead, the cheeks and near the eyes. Treatment for sinus infections includes over-the-counter pain relievers, decongestants, antibiotics, humidifiers, nasal irrigation, steam inhalation, rest, hydration and warm compresses.
Nasal Allergy MedicationsNasal allergy medications are used to relieve itching, sneezing, and nasal swelling associated with allergies. Antihistamines, decongestants, and steroids are different types of nasal allergy medications. Possible side effects of these medications include dryness, stuffiness, burning, bleeding, nervousness, and palpitations.
Nasal IrrigationClogged sinuses and congestion bothering you? Nasal irrigation can relieve sinus symptoms associated with colds and allergies. Learn how to do nasal irrigation with this visual guide from WebMD.
All About PolypsDo you know what a polyp is? Learn the definition of a polyp, which can be found in the sinuses, stomach, colon, gallbladder, and elsewhere. Learn about endometrial polyps, adenomatous polyps, sessile polyps, pedunculated polyps, uterine polyps, and cervical polyps. Some are more likely to cause cancer.
Sinus Infection Dos and Don'tsIs it OK to fly when you've got sinusitis? How about going to work? WebMD helps you decide what's right and wrong when you're all stuffed up.
Sinus Infection (Sinusitis)
Sinus infection (sinusitis) is caused by allergies, infection, and chemicals or other irritants of sinuses. Signs and symptoms are headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Sinusitis SlideshowSinus infection (sinusitis) symptoms can include headaches, a sore throat, and toothaches. Antibiotics and home remedies can relieve sinus infection symptoms.
sodium chloride - intranasal spray (Ocean, Ayr Saline, Humist, NaSal, Little Noses, Ocean)
Sodium chloride intranasal spray (Ocean, Ayr Saline, Humist, NaSal, Little Noses, Ocean for Kids) is an over-the-counter (OTC) product used to relieve nasal dryness and congestion. Sodium chloride intranasal spray also is used as a pretreatment for nasal steroid administration. Common side effects include:
- Nose irritation
Drug interactions, dosage, and pregnancy and breastfeeding information should be reviewed prior to using any OTC product.
What Is the Fastest Way to Get Rid of a Sinus Infection?Learn what medical treatments can help ease your sinus infection symptoms and speed up your recovery.
What Is Bromelain Good For?Bromelain is a naturally occurring substance derived from the fruit, juice and stems of pineapples. Bromelain may be good for digestion, removing dead skin cells from burns and reducing inflammation, swelling, muscle soreness, pain and nasal congestion.