What is chronic sinusitis? Chronic sinusitis, also called chronic rhinosinusitis, is long-lasting inflammation of the lining of the nose and sinuses. Symptoms generally continue for at least 12 weeks, even though their intensity may change over time.
Common symptoms Typical symptoms include nasal blockage, thick nasal or postnasal drainage, facial pressure and a reduced sense of smell. Some patients also experience cough, bad breath, ear pressure or fatigue. Facial pain alone does not always mean sinusitis, so an accurate diagnosis is important.
Why does it happen? Chronic sinusitis is usually driven more by persistent inflammation than by a single ongoing infection. Contributing factors may include allergies, nasal polyps, asthma, a deviated septum, impaired sinus drainage, exposure to irritants or, less commonly, immune problems.
How is it diagnosed? An ENT assessment may include medical history, examination of the nose and nasal endoscopy. A CT scan may be requested when symptoms are prolonged, surgery is being considered, or the diagnosis remains uncertain. Imaging is not required for every patient. Allergy assessment may also be useful in selected cases.
Treatment Treatment aims to reduce inflammation and improve drainage. Saline nasal irrigation and prescribed corticosteroid nasal sprays are common first-line treatments. Antibiotics are not automatically required because chronic sinusitis is not always caused by bacteria. Short courses of other medicines may be considered depending on the individual condition, including the presence of polyps or asthma.
When is surgery considered? Endoscopic sinus surgery may be discussed when symptoms remain significant despite appropriate medical treatment and the examination or imaging confirms disease that may benefit from surgery. Surgery is usually part of a long-term management plan rather than a permanent cure by itself.
When should you seek assessment? See a doctor when nasal blockage, drainage, smell loss or facial pressure lasts for several weeks, repeatedly returns, or affects quality of life. Urgent assessment is required for swelling around the eye, visual changes, severe headache, neck stiffness or neurological symptoms.
This article is for general education and does not replace an individual medical assessment.
Frequently Asked Questions
When is sinusitis considered chronic?
Symptoms generally need to persist for at least 12 weeks.
Are antibiotics always needed?
No. Chronic sinusitis is often inflammatory, and antibiotics are used only when clinically appropriate.
Can allergies contribute?
Yes. Allergies may worsen nasal inflammation and sinus drainage.
Does every patient need a CT scan?
No. Imaging is usually reserved for selected cases, prolonged symptoms or surgical planning.
Can surgery cure chronic sinusitis permanently?
Surgery may improve drainage and symptoms, but ongoing medical care may still be required.
This information is for education only and does not replace medical assessment or treatment by a qualified physician.