Chronic Sinusitis – Causes, Symptoms & Treatment

Chronic sinusitis

In medical jargon, chronic sinusitis is a permanent inflammation of the paranasal sinuses . It is caused by a viral or bacterial infection of the nose and can be treated with various medications.

What is chronic sinusitis?

Chronic sinusitis refers to an inflammation of the mucous membrane in the paranasal sinuses that does not completely subside. One speaks of a chronic disease when the symptoms still exist after two to three months.

The disease occurs relatively frequently and in its acute form mostly affects the maxillary sinus and the ethmoid. Chronic sinusitis also occurs in these areas, but it can spread further.


Chronic sinusitis occurs as a result of acute sinusitis. This in turn is triggered by an inadequately treated cold or a sore throat .

If you don’t react in time, the symptoms will become chronic. Certain allergies to pollen, house dust or other foreign bodies can also trigger the disease. However, chronic sinusitis can also be cured by taking appropriate measures.

The reason for chronic inflammation of the paranasal sinuses can also be anatomical. A bent nasal septum , enlarged turbinates or nasal polyps have a particularly negative effect on the course of the disease.

Symptoms, Ailments & Signs

Chronic sinusitis can cause a variety of symptoms. Typical of the disease are recurring colds, which are accompanied by a cold , headache , stuffy nose and other classic symptoms and complaints. There is usually a discharge that is yellow-greenish, purulent and viscous.

It drains out of the nose and down the throat, closing up the nasal cavities. Poor nasal breathing occurs, which can cause dizziness, a drop in performance and severe discomfort. Accompanying this, the perception of smell and taste is usually reduced. The patient usually also experiences a feeling of congestion in the face, which increases in intensity as the disease progresses.

The facial pain is usually stabbing, boring or pulsating. They appear more often over the forehead, nose or cheek and often radiate to the middle of the skull or in the area between the eyes. It is typical of the disease that the pain intensifies when the affected person bends forward quickly, stands up or hops on one leg. Chronic sinusitis can be limited to a single paranasal sinus, but it can also occur in the entire nasopharynx. It is often accompanied by fever or polyp formation .

Diagnosis & History

In order to be able to diagnose chronic sinusitis, the acute underlying disease must first be clearly identified as such. This is done based on the typical symptoms of a sinus infection. These include pain in the forehead or upper jaw area, purulent runny nose, problems with the sense of smell and a stuffy nose .

If these symptoms are not present, sinusitis can usually be ruled out. In the case of chronic sinusitis, however, the diagnosis is more difficult because the symptoms are much weaker and only occur in episodes.

If there is a high probability of sinusitis, an endoscopic examination is usually carried out to confirm the diagnosis. The endoscope is inserted into the mouth and nostrils to detect escaping secretions and swelling. The secretions are also examined to identify the cause of the sinusitis. The appropriate medication is then prescribed. Chronic sinusitis is only diagnosed when various preparations do not work.

In addition, further examinations such as computer tomography and various allergy tests are carried out so that an operation is possible. In addition, dental check-ups and smell tests can be useful to avoid concomitant diseases. The disease is usually not fatal for those affected, but severely restricts the quality of life and sometimes causes major problems in everyday life.


One speaks of chronic sinusitis when the inflammation has not cured after two to three months. After that, there is still a chance that the disease will go away on its own, but other steps are taken to prevent it from spreading. Medication and a change in external circumstances can make chronic sinusitis more comfortable for those affected.

However, it cannot always be completely cured and some patients have to take medication against it for the rest of their lives. Chronic sinusitis can spread, spread to, and damage adjacent areas of the body. If no medical treatment is given, serious complications can arise.

The eyes are particularly at risk. The paranasal sinuses and the eyes are separated by a thin plate of bone. Inflammation can damage it so much that a breakthrough occurs and bacteria can get directly into the eye socket. This can result in severe eye damage and even blindness.

The brain is also considered to be at risk in chronic sinusitis. If the bony separation between the brain and the paranasal sinuses breaks through, meningitis may result. This can be a life-threatening threat and urgently requires medical treatment. There is also a risk that pus will settle in the brain structures and abscesses will form. It is also possible for blood clots to form in the cerebral veins ( thrombosis ).

There is also a risk of attack on the teeth. It is not uncommon for tooth root inflammation to have its origin in chronic sinusitis. If left untreated, breathing through the nose becomes increasingly worse. A consequence of this is snoring.

When should you go to the doctor?

A chronification of simple sinusitis is to be seen as a complication. For this reason, any chronic sinusitis requires medical attention. Serious complications can only be avoided if a doctor is consulted in good time.

In advanced stages, surgical therapy is usually unavoidable. Otherwise, the symptoms will not improve. If a major operation is to be avoided, it makes sense to consult a doctor as early as possible. As a rule, consultation with a doctor is appropriate if the symptoms of acute sinusitis persist beyond the usual period. In this case, the doctor can intervene – often by administering an antibiotic.

A significant improvement in the stressful problem can usually be achieved just a few weeks after consulting a doctor. The right contact person in this case is the specialist in ear, nose and throat medicine, who has a wide range of diagnostic and therapeutic options at his disposal. This specialist doctor can also be consulted without a referral from your family doctor .

Treatment & Therapy

After chronic sinusitis has been diagnosed, various measures can be initiated. If allergies are the cause, antiallergic drugs and nasal spray are prescribed. So-called hyposensitization is also part of some therapies. Antibiotics and nasal rinses are also prescribed to flush out bacteria and alleviate the symptoms.

In some cases, a change in diet can also help against chronic sinusitis. This is the case when there is a food intolerance . In any case, an expert must be consulted to treat the condition effectively. In the meantime, apart from lengthy therapies, there is also the possibility of surgically resolving the symptoms. The closed connecting passages are expanded with the help of a balloon. However, this so-called siluplasty is only suitable for simple cases of chronic sinusitis.

Treatment methods used for acute sinusitis can at least relieve the symptoms of the chronic form. Common therapies include steam inhalation, acupuncture , and the use of essential oils .

Outlook & Forecast

The prognosis of chronic sinusitis is individual and cannot be predicted uniformly for all those affected. Despite the chronic course of the disease, a large number of patients are cured and completely free of symptoms.

There is also the possibility of a continuous course of the disease, in which the patient has lifelong impairments. If the doctors can restore ventilation to the sinuses, there is a good chance of recovery. An attempt is made to achieve this goal in a surgical procedure. Success depends on the severity of the disease, the age of the patient and their general health.

By restoring the ventilation of the paranasal sinuses, the functional activity of the mucous membranes can be regenerated. This process is essential for a good prognosis and can take place within a few weeks if the operation is successful. In addition, the patient must take part in specified follow-up and check-up examinations after the procedure so that a good course can be guaranteed.

The prognosis worsens when the disease has already spread to the surrounding areas of the face. If the eyes or teeth are already affected by chronic sinusitis, lifelong damage can result. A complete recovery is no longer possible, for example, if you have already been blinded by chronic sinusitis.


Sinusitis becomes a chronic disease mainly due to a lack of early detection of the causes. So, a preventive measure is a visit to an otolaryngologist , when the first symptoms appear.

In addition, colds , sore throats and colds must be sufficiently cured so that no chronic symptoms develop. In general, it helps to drink a lot, rinse your nose regularly with a lukewarm saline solution and air the apartment well.

In addition, an allergy test can help to contain the symptoms. Hyposensitization also prevents chronic sinusitis. Finally, care should be taken to ensure a healthy, hardened immune system . Sufficient exercise and a healthy diet are essential for preventing chronic sinusitis.


Chronic sinusitis is a long-term inflammation of the paranasal sinuses. This can be very stressful for the patient. Therefore, treatment with decongestant cortisone sprays and appropriate aftercare is necessary after practically every cold . If necessary, an operation must create a pressure relief.

If the connecting passages between the paranasal sinuses are narrowed by curvatures in the nasal septum or are blocked by polyps, frequent sinus infections are the result. Chronic sinusitis can often be successfully treated with conventional means. Cortisone sprays are usually used to improve breathing and relieve pressure.

However, if conservative treatment is not permanently successful, the symptoms of chronic sinusitis can only be remedied by means of surgical intervention or sanitation of the paranasal sinuses under general anesthesia. The curvature in the nasal septum is often surgically corrected. Follow-up care is required because bleeding and persistent swelling occasionally occur postoperatively .

There is also a risk that the problems will not prove to be resolved in the long term. It becomes complicated, for example, if the patient has to use a nocturnal ventilation aid because of sleep apnea . The nocturnal breathing aid cools the airways to such an extent that chronic sinusitis is practically impossible to get a grip on. Here, the aftercare measures can only ensure that the patient who has already been operated on experiences medical pressure relief whenever he has a cold.

You can do that yourself

In the case of chronic sinusitis, the person affected can supportively pay attention to their lifestyle in order to improve their own health. Smoking should be avoided entirely, as should staying in smoking areas or rooms A healthy diet improves well-being and stabilizes the immune system so that the organism can independently produce sufficient defences.

When it comes to food intake, it is therefore important to ensure that the diet is rich in vitamins and that there should also be sufficient exercise. Fluid intake is important. The nasal mucosa needs enough liquid to regenerate. During the winter months, the indoor air is often dry and in the summer months, the outside temperatures can promote dehydration of the mucous membranes. The organism should therefore be supplied with liquid with around two liters a day.

When dealing with other sick people, particular hygienic behavior must be observed. Hands are to be disinfected and nasal sprays or handkerchiefs are not to be shared with other people. It should be ensured that no other pathogens can enter the organism. Especially in cold seasons, the number of germs is significantly increased. For this reason, it is important to act cautiously so that your own immune system is not even more heavily burdened and the healing process is not made more difficult.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.