Sinusitis is the clinical term for inflammation of the sinuses, so chronic sinusitis involves long-term inflammation. It can be caused or accompanied by polyps growing in the sinus cavities, or involve a fungal infection that triggers constant allergic reactions.
Almost anything that irritates the sinuses, such as acid reflux or exposure to environmental irritants, can lead to chronic sinus problems. Many untreated acute sinus infections also turn chronic until treated.
Symptoms of chronic sinusitis include:
Unlike acute sinusitis, chronic sinusitis is not usually caused by an infection, but instead by long term inflammation or blockages in the sinuses. Although some instances of chronic sinusitis could be triggered by an infection such as a cold, the effects do not usually last long enough – over 12 weeks – for a diagnosis of chronic sinusitis, unless the individual is already susceptible to sinusitis due to other health conditions discussed below.
Allergies can often cause chronic sinusitis because the immune system responds to allergens by causing inflammation of the sinuses. For this reason people with hay fever frequently develop chronic sinusitis during spring and summer when pollen counts are particularly high.
Nasal polyps are another potential cause of chronic sinusitis. These are growths which can block the sinuses and nasal passages, which leads to a buildup of mucous in the sinuses and causes symptoms of sinusitis. Similarly, some people develop chronic sinusitis if they have a deviated septum. If the septum is crooked enough to restrict the sinus passages, mucous may become blocked.
Treatments are usually self-administered in cases of mild to moderate chronic sinusitis.
Patients are sent home with oral antibiotics and anti-fungal medication to clear out lingering infections, decongestants and steroid sprays to reduce swelling from inflammation, antihistamines, and mild pain-killers.
For serious cases linked to a polyp or other change in the sinus cavity itself, surgery fixes the problem and allows drainage to resume. Chronically inflamed tissue can also be removed to keep the sinuses open and reduce pain. Most patients will also need to make lifestyle changes like eliminating allergens from their home to prevent acute or chronic sinusitis from returning.
To prevent chronic sinusitis, it’s important to try to get other underlying conditions which increase the risk of the illness under control. For example, someone with allergies who is prone to sinusitis during peak hay fever season should consult their doctor about treatments that could relieve their allergic response. This might be medications, injections or nasal sprays.
To prevent chronic sinusitis caused by conditions which affect the structure of the nose and sinuses, such as a deviated septum or nasal polyps, surgery may be the only prevention. However, many of these surgeries are relatively routine and can significantly improve the ability to breath while reducing the risk of sinusitis, and can therefore have a very positive impact on quality of life.