A cold usually improves within days, but sinus symptoms that continue for a long period require a different assessment. Chronic rhinosinusitis is persistent inflammation of the lining of the nose and sinuses. It can affect breathing, sleep, smell, concentration and quality of life, and it is not simply a long-lasting bacterial infection.
Common symptoms
Typical symptoms include nasal blockage or congestion, thick nasal drainage, mucus running down the throat, facial pressure or fullness, and a reduced sense of smell. Some people also experience cough, bad breath, fatigue, ear pressure or disturbed sleep. Facial pain alone does not confirm sinusitis; migraine, dental disease and other conditions can cause similar discomfort.
What causes chronic sinus inflammation?
Several factors can contribute, including nasal polyps, allergies, asthma, a deviated nasal septum, impaired sinus drainage, exposure to smoke or irritants, and certain immune or inflammatory conditions. Because causes vary, repeated antibiotics without a clear indication may not resolve the problem.
How is chronic sinusitis diagnosed?
An ENT doctor will ask about the duration and pattern of symptoms, allergies, asthma, previous treatments and operations. The examination may include nasal endoscopy, which uses a small camera to inspect the nasal passages. A CT scan may be requested when needed to assess the sinuses and plan treatment. Allergy or other tests may be appropriate in selected cases.
Treatment options
Treatment aims to reduce inflammation, improve drainage and address contributing conditions. Saline nasal irrigation and prescribed intranasal corticosteroid sprays are commonly used. Technique matters: use only sterile, distilled, or previously boiled and cooled water for nasal rinsing, and clean the device as directed. Other medicines may be considered according to the cause. Antibiotics are useful only in selected situations and should be prescribed by a clinician.
If symptoms remain significant despite appropriate medical treatment, an ENT surgeon may discuss endoscopic sinus surgery. Surgery is intended to improve ventilation and drainage and help topical treatment reach the sinuses; ongoing medical care may still be needed afterward, especially for allergy or nasal polyps.
When should you seek urgent help?
Prompt medical attention is important for swelling around the eye, double or reduced vision, severe headache, neck stiffness, confusion, high fever or rapidly worsening symptoms. These findings are uncommon but may signal a complication.
When to book an ENT assessment
Arrange an appointment if congestion, drainage, facial pressure or loss of smell persists for weeks, repeatedly returns, or affects sleep and daily activities. A proper diagnosis helps distinguish chronic sinusitis from allergy, migraine and other causes and prevents unnecessary treatment.
This information is general and does not replace examination by a healthcare professional.