Chronic sinusitis

Symptoms, diagnosis and ENT treatment

Table of Contents

Chronic sinusitis, more precisely chronic rhinosinusitis, is persistent inflammation of the lining of the nose and paranasal sinuses, with symptoms lasting at least 12 weeks. It can cause a blocked nose, discharge, reduced sense of smell and facial pressure.

At Tartaczna 2 Medical Centre in Gdańsk, ENT assessment and treatment are provided by Dr Agnieszka Kasprzyk-Tryk. Care is tailored to the patient's age, symptoms and examination findings.

What are the symptoms of chronic sinusitis?

Typical symptoms include:

a blocked nose and difficulty breathing through the nose,
nasal discharge or mucus running down the back of the throat,
a reduced or lost sense of smell,
facial pain, pressure or a feeling of fullness.

Assessment for chronic sinusitis considers at least two main symptoms, including nasal blockage or discharge, lasting a minimum of 12 weeks. A headache alone is not enough to establish the diagnosis. Symptoms must be considered alongside the ENT examination and any investigations that are needed.

What can contribute to persistent sinus problems?

Relevant factors include ongoing inflammation, nasal polyps, coexisting allergy or asthma and certain anatomical abnormalities. A dental cause should be considered in some patients, particularly with symptoms affecting one maxillary sinus. Tobacco smoke can irritate the nasal lining and worsen symptoms.

Chronic sinusitis does not always mean a persistent bacterial infection. In children, other causes of long-term nasal obstruction, including enlarged adenoids and allergy, also need to be considered.

How is chronic sinusitis diagnosed?

The ENT specialist asks about symptom duration, previous treatment, allergies, asthma and any nasal or dental procedures. They examine the nose for inflammation or polyps. Depending on the findings, nasal endoscopy or a CT scan of the sinuses may be needed.

Not everyone needs a CT scan at the first appointment. Investigations are selected according to the diagnostic question, the course of the condition and the proposed treatment. Allergy tests or other investigations are arranged when indicated.

How is chronic sinusitis treated?

Nonsurgical treatment usually involves saline nasal rinses and suitable anti-inflammatory nasal medicines, particularly corticosteroid sprays. Regular use and correct application technique matter. The doctor chooses the treatment plan and suitable products, especially for children.

Antibiotics are not routinely needed for every case of chronic sinusitis. They may be appropriate in selected situations, such as a suspected bacterial flare-up. Decongestant nasal drops are unsuitable for long-term use; overuse can make nasal blockage worse.

If symptoms persist despite appropriate treatment, the ENT specialist considers further investigations or referral for surgery. Surgery requires a separate assessment; a clinic consultation does not automatically mean an operation is needed.

Nasal rinsing and daily care

Prepare nasal rinses using sterile, distilled or previously boiled and cooled water, following the kit instructions. Keep the device clean. Do not use untreated tap water or add essential oils.

Avoid tobacco smoke and follow your treatment plan. Steam inhalation over a bowl of hot water carries a burn risk, particularly for children. Supplements and home remedies do not replace assessment or treatment of persistent inflammation.

When do sinus symptoms need urgent attention?

Swelling or redness around an eye, changes in vision, a severe worsening headache with fever, neck stiffness or altered consciousness require urgent medical assessment. Do not wait for a routine ENT appointment.