Your sinuses are hollow cavities behind your nose, cheeks and forehead that produce mucus to protect against pollutants while also keeping your nose moist. Because of their role in your respiratory system, your sinuses are often susceptible to viruses, leading to colds.
When the sinus cavities become blocked or inflamed, causing mucus to build up, it could lead to acute sinusitis, or a sinus infection. This condition affects 31 million people in the United States every year.
“Symptoms include congestion, facial pressure, tooth pain and drainage of mucus in the throat,” says Cristine Klatt-Cromwell, MD, an otolaryngologist (ear, nose and throat doctor) at UNC Health. “For most people, it’s about eight to 10 days of symptoms. It usually gets better on its own, but you can treat it with nasal rinses, sprays and over-the-counter decongestants.”
Bacteria can also cause or lengthen acute sinusitis, so if your infection hasn’t cleared up in 10 days, your doctor may prescribe antibiotics.
If your symptoms don’t resolve after treatment, or if you find yourself with multiple sinus infections in a year, you may have a case of chronic sinusitis. We spoke to Dr. Klatt-Cromwell about it.
What is chronic sinusitis and how is it treated?
Chronic sinusitis is typically defined as sinus infection symptoms that last 12 weeks or more, but Dr. Klatt-Cromwell says you don’t have to wait that long before consulting a doctor.
It can be caused by structural issues that lead to blockages of the sinuses, such as nasal polyps or a deviated septum. If you have allergies, asthma or an autoimmune disease, you may be more at risk for this condition because of ongoing inflammation in the nose. If you have a weakened immune systems due to immunosuppressive medications, such as ones taken after cancer treatment or a transplant, you also may experience chronic sinusitis.
Treatment of sinusitis is based on the cause. If chronic sinusitis is due to allergies or asthma, for example, then antihistamines, nasal sprays or allergy shots may help.
“Some people use these tools intermittently, but they may see sinusitis improve when they use them continuously,” Dr. Klatt-Cromwell says. “We’ll check that they’re using nasal rinses or sprays with proper technique.”
Your doctor may order imaging or perform a nasal endoscopy (a thin tube with a tiny camera is used to look at the sinuses) to determine whether structural issues are causing pressure or blockages, and whether symptoms are related to a sinus infection or something else.
“Cerebrospinal fluid leaks and tumors can be mistaken for sinusitis,” Dr. Klatt-Cromwell says. “Or, some people may think they’re having sinus headaches, because they feel it in their face or forehead, but they’re actually having migraines.”
Steroid nasal sprays or oral steroids are often prescribed when over-the-counter medications, regular rinses or antibiotics have failed. If those don’t work, or if your doctor identifies a structural issue, you may need surgery.
How does surgery help with sinusitis?
Several procedures can help with chronic sinusitis.
A balloon sinuplasty uses a small balloon to widen the sinus passage and flush out blockages; this is minimally invasive and typically done without general anesthesia. Surgery might be recommended to remove large polyps or correct a deviated septum. Endoscopic sinus surgery involves the cutting of bone to enlarge the sinus cavity and the removal of inflamed tissue.
With endoscopic sinus surgery, you should expect some pain afterward.
“Recovery takes about a week, and it’s frequently uncomfortable,” Dr. Klatt-Cromwell says. “There will be bloody drainage and fatigue.”
It’s important to note that these procedures won’t necessarily prevent future sinus infections, though they may make standard treatments more effective.
“Surgery is just one step of long-term medical management,” Dr. Klatt-Cromwell says. “You will still have to follow through on managing allergies or inflammatory disease or performing nasal rinses to have a good outcome.”
Can sinusitis be prevented?
You can prevent sinus infections by practicing good hand hygiene during cold and flu season, following recommendations to manage your allergies or asthma, avoiding nasal irritants such as cigarette smoke, using saline nasal rinses, and keeping nasal passages hydrated by using a humidifier and drinking lots of water.
Struggling with sinus infections? Talk to your doctor. If you need a doctor, find one near you.