Also known as: Chronic Rhinosinusitis (CRS)
Chronic sinusitis is inflammation of the sinuses lasting 12 weeks or longer despite treatment. It causes nasal congestion, facial pain, reduced smell, and post-nasal drip.
Chronic rhinosinusitis affects approximately 5-12% of the general population and has a significant impact on quality of life, comparable to conditions like heart failure and COPD.
Two main subtypes exist: CRS with nasal polyps (CRSwNP, associated with type 2 inflammation and often co-existing asthma) and CRS without nasal polyps (CRSsNP, more associated with infection and anatomical factors).
Treatment is multimodal: nasal saline irrigation and corticosteroid sprays are foundational. Biologics (dupilumab) have transformed management of CRS with nasal polyps.
People with Chronic Sinusitis often experience the following symptoms.
Persistent nasal congestion that does not respond to decongestants, affecting breathing and sleep.
Dull pain or pressure over the cheeks, forehead, or between the eyes, worse with bending forward.
Reduced or lost sense of smell, particularly common in CRS with nasal polyps.
Mucus dripping from the back of the nose into the throat, causing cough, throat clearing, and sore throat.
Certain factors may increase your likelihood of developing Chronic Sinusitis.
Common approaches to managing chronic sinusitis. Always consult a healthcare provider for personalized treatment.
High-volume saline rinse (neti pot or squeeze bottle) twice daily is the foundation of chronic sinusitis treatment.
Fluticasone, mometasone, or budesonide sprays reduce inflammation and polyp size.
Dupilumab, omalizumab, and mepolizumab for CRS with nasal polyps not controlled by conventional treatment.
Functional endoscopic sinus surgery (FESS) to open blocked sinuses and remove polyps when medical therapy fails.
Symptoms persisting 12+ weeks with objective evidence of inflammation: nasal endoscopy showing polyps, mucosal oedema, or purulence, and/or CT scan showing sinus opacification.
See a doctor if sinus symptoms persist beyond 12 weeks, recur frequently, or are accompanied by high fever, severe headache, vision changes, or facial swelling.
Steps that may help reduce the risk of developing or worsening chronic sinusitis.
Manage allergies
Nasal saline irrigation regularly
Avoid smoking and pollutants
Treat acute sinusitis promptly
If left untreated or poorly managed, chronic sinusitis may lead to:
CRS without polyps can often be effectively managed. CRS with polyps tends to recur but biologics have dramatically improved control.
Only if medical therapy fails. Most patients can be managed with nasal irrigation, steroids, and if needed, biologics.
Smell often improves with treatment (especially steroids and biologics). Prolonged untreated disease may cause more persistent loss.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.