With chronic sinusitis, the sinus or nasal passage becomes inflamed for 12 weeks or longer, despite treatment, and causes at least two of the following symptoms:

Chronic Sinusitis

  • A decreased sense of smell
  • Facial pain, pressure 
  • Nasal congestion
  • Mucus discharge or post-nasal drip 
  • Headache and fever

Contrary to acute sinusitis, usually caused by infection, chronic sinusitis has more complicated causes. Chronic sinusitis is categorized into:

  • Chronic sinusitis without nasal polyps
  • Chronic sinusitis with nasal polyps
  • Allergic fungal rhinosinusitis

Risk Factors

Several factors increase your risk of chronic sinusitis. These include:

  • Allergies
  • Deviated septum and enlarged turbinates
  • Exposure to smoke and cigarette smoking
  • Tumors
  • Dental infection
  • Immune system disorders


Both patients and medical practitioners sometimes neglect chronic sinusitis because the symptoms are less serious and chronic. In general, the diagnosis of chronic sinusitis is made by symptoms alone. Chronic sinusitis is most likely if a person has had two or more of the symptoms mentioned above for at least three months.

However, sometimes the symptoms aren’t well defined. To diagnose, other tests can be performed. For example, a doctor will examine inside your nose to get a clear look at the nasal or nasal drip; this is known as rhinoscopy. The procedure takes about a quarter-hour and involves a series of radiographs of the head and face. X-rays can be done to visualize the sinuses. The benchmark to diagnose is a CT scan. Other tests are only done in exceptional circumstances.


There is not a lot we can do to treat the disease itself. Treatment should focus on:

  • Regulating triggers
  • Decreasing inflammation
  • Eliminating the infection

Regulating triggers

Allergy testing aids in recognizing environmental triggers that patients should avoid.

Medical Management

  • Nasal spray with steroids helps with inflammation. The treatment should last at least eight weeks to 3 months with appropriate usage.
  • Nasal saline washing. Daily washing of nasal passages helps relieve congestion in the nose.
  • Antihistamine: should only be used if an allergic element is suspected.
  • Nasal decongestants can momentarily relieve a blocked nose. Not be used for more than 5-7 days at a time.
  • Antibiotics can be prescribed if an infection causes sinusitis. They can be given for three weeks.
  • Pain killers help ease any pain, such as Ibuprofen(Advil) and Tylenol (Acetaminophen).

Surgical Management

  • Endoscopic sinus surgery: A doctor may suggest surgery in some cases if home treatments and medication don’t help. This surgery aims to relieve blockages, restore drainage and mucus clearance, and ventilate the sinuses.
  • (septoplasty)(deviated septum surgery) or rhinoplasty (nose surgery): Your doctor modifies the wall between your nostrils to straighten it out or enlarge it. This can help you to breathe smoothly.

Final Point

Depending on the cause of your chronic sinusitis, the symptoms may fail to be fully treated. You may need extended treatment to prevent your symptoms from getting in the way of your daily life.

However, in many cases, management of symptoms can be done with home remedies, painkillers, and a treatment plan established with your doctor to address its particular causes.

Visit our experts at Roanoke Valley ENT & Allergy if you have been diagnosed with chronic sinusitis or suspect you have sinus health concerns. You can request an appointment online or call 540-655-1888.