Chronic sinusitis is medically known as chronic sinus infection. It is swelling (inflammation) of the air-filled spaces (sinuses) behind the forehead, cheeks, and eyes, which continues for a long time or keeps coming back.

Causes

The sinuses are openings in the bones around the nose. Four pairs of sinuses connect to small openings in the nose area. Normally, air passes in and out of the sinuses, and mucus and fluid drain from the sinuses into the nose.

Sinusitis is usually due to allergies or infection. When sinusitis keeps coming back or continues for a long period of time, it is considered chronic.

Causes of chronic sinusitis include:

Blockage in the nose from allergies, nasal polyps, nasal tumors, or a deviated nasal septum
Dental infections such as tooth abscess
Allergy to the aspergillus species of fungus

Chronic sinusitis is much less common than acute sinusitis. Acute sinusitis often occurs with upper respiratory infections. Chronic sinusitis may produce less severe symptoms than acute sinusitis, but it can damage the tissues of the sinuses.

Symptoms

Symptoms may last for 3 months or more.

Chronic fatigue
Cough
Facial pain around the eyes or in the forehead or cheeks
Headache (in the front of the head or around the eyes)
Nasal congestion
Nasal drainage (yellow, yellow-green, thick)
Pain in the roof of the mouth or teeth

Exams and Tests

The health care provider will examine you and tap lightly on your face over your sinuses. This method is called percussion. It may reveal tenderness in the area.

Normal sinuses glow when light shines directly onto them. If sinusitis is present, the sinuses will not glow when your doctor shines a light onto them.

Other tests that may be done include:

CT scan of the sinuses
MRI of the sinuses
Sinus x-rays

These imaging tests may show the sinuses to be filled with fluid or reveal thickening of sinus tissues.

Treatment

The goal of treatment is to cure the infection and make symptoms go away.

Antibiotics may be given if the infection is caused by bacteria. Antibiotic treatment usually takes 3 - 4 weeks.

Pills taken by mouth that help relieve a stuffy nose (oral decongestants) are sometimes used. Nasal sprays (topical steroids) may help relieve symptoms of chronic sinusitis that are due to allergies.

Over-the-counter painkillers (analgesics) may be used to control pain.

Surgery to clean and drain the sinuses may be needed. Surgical repair of a deviated septum or nasal obstruction may prevent chronic sinusitis from coming back.

Outlook (Prognosis)

Chronic sinus infections can usually be cured, but may need treatment over a long period of time.

Chronic sinusitis tends to come back, especially if conditions such as nasal blockages are not treated.

Possible Complications

Abscess forms, including (rarely) brain abscess

Chronic sinusitis comes back

Infection spreads to area around the eye, possibly causing vision damage or blindness

Infection spreads to the bones of the face (osteomyelitis)

Infection spreads to the brain (meningitis)

When to Contact a Medical Professional

Call for an appointment with your health care provider if you develop symptoms of chronic sinusitis. Also call if acute sinusitis symptoms do not improve with treatment.

Prevention

Using decongestants when you have an upper respiratory infection may reduce your risk of developing sinusitis. However, decongestant nasal sprays should only be used for short periods of time, or they can make congestion worse. This is called rebound congestion or rhinitis medicamentosa.

Chronic sinusitis is a type of sinusitis that lasts from three weeks to eight weeks. It is quite hard to treat chronic sinusitis because it sometimes does not respond to antibiotics easily.

Antibiotics therapy is recommended for chronic sinusitis however, it may take sometime before the antibiotics will take affect that is why chronic sinusitis requires long term use of antibiotic.

In terms of therapy, the patient is prescribed with the proper antibiotics and corticosteroid spray as it helps in lessening the inflammation of nasal passages.

The cause of sinusitis may vary from one person to another. There are some instances that a sinus infection is cause by bacterium or fungus. People who also have poor immune system are vulnerable in having chronic sinusitis. Likewise people who have been using oral corticosteroid medicines for long term use are also prone to have sinusitis.

Antibiotics is the first medical option in treating chronic sinusitis but if the patient have been using the antibiotic for long term use but the symptoms do not go away, then, surgery will be considered.

Manage Your Sinusitis

Here are some tips that will help you in managing your sinusitis:

Treat immediately your colds and allergies to help you prevent an infection that might lead to sinusitis.
Avoid smoking. Smoking can inflame further your sinusitis.
Drink plenty of water
During attack of chronic sinusitis, you may use saltwater nasal washes to help your nasal passages.
Use a humidifier to add moisture in the air.