Patient education: Chronic sinusitis (The Basics)

What is chronic sinusitis? — Chronic sinusitis is a long-lasting form of sinusitis. Sinusitis is a condition that causes a stuffy nose, pain in the face, and discharge or "mucus" from the nose. Chronic sinusitis can also make you feel tired and run down all of the time.

The sinuses are hollow areas in the bones of the face (figure 1). They have a thin lining that normally makes a small amount of mucus. When this lining gets inflamed, it swells and makes extra mucus.

The most common type of sinusitis often happens after you catch a cold. It is also called "acute sinusitis." It usually gets better in 1 to 3 weeks.

Chronic sinusitis lasts for at least 3 months. People with this condition often have very swollen sinuses. One or more sinuses might get filled with mucus. Some people get abnormal growths inside their noses or sinuses, called "polyps" (figure 2). People with nasal polyps often have a poor sense of smell.

What are the symptoms of chronic sinusitis? — People with chronic sinusitis have at least 2 of the following symptoms for at least 3 months:

●Stuffy nose

●Yellow, green, or brown mucus that drains from the nose or down the back of the throat

●Pain, pressure, or a feeling of "fullness" in the face

●Not being able to smell things as well as usual

●Cough (more common in children)

Should I see a doctor or nurse? — If you have at least 2 of the above symptoms for more than 3 months, see your doctor or nurse. They can help figure out if you have chronic sinusitis.

Call your doctor or nurse right away if you have:

●Fever higher than 102.5°F (39.2°C)

●Sudden and severe pain in the face and head

●Trouble seeing, or seeing double

●Swelling or redness around 1 or both eyes

●Very bad headache or stiff neck

Are some people more likely to get chronic sinusitis than others? — Yes. You might be more likely to get chronic sinusitis if you:

●Have allergies – Allergies to molds, cockroaches, dust mites (tiny insects found in dust), and animal dander (tiny flakes from animal fur, hair, or skin) are most likely to cause sinus problems. Things that cause allergies are called "allergens."

●Have problems with your immune system – The immune system is the body's infection-fighting system.

●Get frequent colds

●Have an injury or deformity of the nose that makes it hard to drain mucus normally

●Smoke cigarettes, or are around others who smoke

Are there tests for chronic sinusitis? — Yes, but they are not always needed. Tests include:

●CT scan or other imaging tests – Imaging tests create pictures of the inside of the sinuses. These tests are not usually done in children unless they do not get better with treatment.

●A test to look inside the sinuses – For this test, a doctor puts a thin tube with a camera on the end into the nose and up into the sinuses.

Is there anything I can do on my own to feel better? — Yes. If you smoke, quit. If you have allergies, talk to your doctor about how to better control your allergy symptoms.

You can also rinse out your nose with salt water. This cleans the inside of your nose and washes allergens and mucus from the nose. Different devices can be used to rinse the nose.

How is chronic sinusitis treated? — Your doctor might recommend different treatments, including:

●Steroids – These medicines help to reduce swelling and mucus, and shrink polyps, if you have them. They can be taken as nose sprays (figure 3) or drops you put in your nose. You can also add steroid medicines to the salt water used for rinsing out your nose. Your doctor also might prescribe steroid pills.

●Biologic medicines – "Biologic" refers to the way these medicines are made. They are taken as a shot under the skin. These medicines also reduce swelling and mucus, and shrink polyps, if you have them. They are often used when people need steroids too often.

●Antibiotics – These are used to treat sinus infections, which sometimes happen when you have chronic sinusitis.

●Surgery – Some people with chronic sinusitis need surgery. The surgery reopens blocked nasal passages and remove polyps or mucus trapped in the nose. But this is usually done only in people who do not get better after trying medicines.

More on this topic

Patient education: Sinusitis in adults (The Basics)
Patient education: How to rinse out your nose with salt water (The Basics)

Patient education: Acute sinusitis (sinus infection) (Beyond the Basics)
Patient education: Chronic rhinosinusitis (Beyond the Basics)