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Chronic sinusitis | Mate taringa-ihu-korokoro
Also known as chronic rhinosinusitis (CRS)
Key points about chronic sinusitis
Chronic sinusitis (mate taringa-ihu-korokoro) is an ongoing inflammatory condition of your sinuses - air–filled spaces in the skull, behind your forehead, eyes, nose and cheeks.
The symptoms last for 3 months or more.
Sinusitis occurs when your sinuses cannot drain properly. It causes a heavy, full feeling in your head that can be painful and uncomfortable.
Chronic sinusitis is treated with medicines, non-surgical treatments, surgery or a combination of these.
There are things you can do to help stop you getting chronic sinusitis.
The sinuses are tiny air spaces in your cheeks and forehead and around your eyes. They're lined with a thin membrane that makes mucus, which drains out through your nose. Sometimes the lining becomes inflamed or infected, making it harder for the mucus to drain properly, and the sinuses become blocked. Chronic sinusitis is when the inflammation or infection lasts for more than 3 months.
Image credit: Canva
Things that can increase your risk of getting chronic sinusitis
The main symptoms of chronic sinusitis are usually a blocked nose (nasal obstruction) and reduced sense of smell.
You may also:
have a headache that becomes worse when you lean forward
have a tender and painful face
have a sore throat, nausea or coughing
have sore ears or teeth
feel generally tired
have puffy eyes
have bad breath
not be able to smell or taste things normally.
Unlike acute sinusitis, chronic sinusitis doesn't often cause a fever.
Diagnosis
Your healthcare provider can diagnose chronic sinusitis by reviewing your medical history, completing an examination and conducting some tests, eg, a CT scan of your sinuses.
Treatment
Often treating the underlying cause will help to improve your symptoms. This may mean treating your asthma, allergies, any dental disease, or quitting smoking. If your chronic sinusitis is because of the structure of your nose and nasal passages (eg, nasal polyps, a deviated septum, narrow nasal passages or tissue thickened by years of infection), then it may involve treating this through surgery.
Self-care
You can try the following things to relieve your symptoms:
Saline rinses done every day can keep mucus loose, remove secretions, reduce post-nasal drip and rinse away allergens and irritants. You can make a home-made sinus rinse solution or you can buy a sinus rinse from your pharmacy. Read more about saline nasal sprays, drops and rinses and watch a video on how to do a sinus rinse below.
Steroid nasal sprays can help to reduce inflammation of your sinus linings, reduce mucus production and help shrink any polyps that may be present. They have the advantage of delivering the medicine right where it is needed. Read more about steroid nasal sprays.
Pain relief medicines (eg, paracetamol or ibuprofen) are not ongoing treatments and should only be used when necessary for the shortest possible time.
Antihistamines, especially ones that are less likely to make your drowsy (eg, loratadine), can be helpful in treating allergy and relieving your sinus symptoms if allergy is the cause. However, they can dry and thicken secretions and make it hard to drain, so they're not suitable for everyone.
Antibiotics may be needed if the inflammation leads to a sinus infection. You may need to take them for several weeks. Your doctor will be the best person to guide you about this kind of treatment.
VIDEO: Sinus rinsing with saline or medication
The following video demonstrates how to do a sinus rinse. It may take a few moments to load.
(Mayo Clinic, US, 2020)
Surgical treatment
If medical treatments don't help, your healthcare provider may refer you to an ear, nose an throat (ENT) surgeon who may offer endoscopic sinus surgery. There are several options:
Functional endoscopic sinus surgery (FESS). This involves a surgeon inserting an endoscope (long tube) into your nose through which they can see what is blocking drainage of your sinuses and remove any tissue that is causing the blockage. This is often all that is needed to improve sinus drainage and ventilation and help to restore normal function to your sinuses.
Nasal surgery. Some people have a deviated septum between the left and right nostrils. This can be caused by an injury or can be something you're born with. Others have extra large nasal turbinates (structures in your nose that clean and moisten the air you breathe). Nasal surgery to correct these problems can be helpful.
Balloon catheter dilation of paranasal sinus ostia. This involves a surgeon pushing a small balloon through a flexible tube in your nostril into the blocked sinus. By inflating the balloon, blocked areas are pushed to the sides, the balloon is deflated and removed, leaving a sinus drainage channel that can drain properly again.
Video: Endoscopic sinus surgery
This surgical video demonstrates the procedure of endoscopic sinus surgery, carried out by Professor Claire Hopkins of Guy's and St. Thomas' Hospital, London, UK. Click anywhere on the image to visit the website, then click play.
(external link) (The Journal of Laryngology and Otology, UK, 2018)
