Chronic Sinusitis

Chronic sinusitis refers to persistent inflammation of the sinus cavities with mucus build-up that typically lasts for more than 12 weeks in duration. The inflammation in the sinuses may be due to infection (viruses, bacteria or fungi), allergies, or other anatomical factors that block the normal flow of mucus out of the sinus cavities (nasal polyps, cysts, curved nasal septum, bone spurs, etc.) In some individuals, the cells lining the sinus cavities do not function properly and are unable to remove the mucus secretions. Patients with this condition often experience nasal congestion, diminished sense of smell, pressure in the face or ears, cough, bad breath, and thick, discolored drainage from the nose or throat. Long courses (21 days or more) of antibiotics are effective in some cases when used with anti-inflammatory medication (nasal or oral steroids), decongestants, mucus thinners and saline rinses. In many patients, the symptoms return again after antibiotics have been discontinued and some patients do not improve with antibiotics. The disorder is diagnosed by symptoms, findings on examination and imaging of the sinuses by CT scan. Aggressive management of allergic disorders can lead to improvement in some patients. Occasionally, surgery is required to assist with drainage of the sinus cavities.