Chronic sinusitis is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen for at least 12 weeks, despite treatment attempts. Chronic sinusitis can be brought on by an infection, by growths in the sinuses (nasal polyps) or by a deviated nasal septum. The condition most commonly affects young and middle-aged adults, but it also can affect children.
Signs and symptoms of chronic sinusitis must be present with the confirmation of nasal inflammation for a diagnosis. These are:
- Thick, discolored discharge from the nose or drainage down the back of the throat (postnasal drainage)
- Nasal obstruction or congestion, causing difficulty breathing through your nose
- Pain, tenderness and swelling around the eyes, cheeks, nose or forehead
- Reduced sense of smell and taste in adults or cough in children
Other signs and symptoms can include:
- Ear pain
- Aching in your upper jaw and teeth
- Cough that might worsen at night
- Sore throat
- Bad breath (halitosis)
- Fatigue or irritability
Chronic sinusitis and acute sinusitis have similar signs and symptoms, but the acute sinusitis is a temporary infection of the sinuses that is often associated with a cold.
Common causes of chronic sinusitis include:
- Nasal polyps: Abnormal tissue growths can block the nasal passages or sinuses.
- Deviated nasal septum: A crooked septum of the wall between the nostrils may restrict or block the sinus passages.
- Other medical conditions: Complications of cystic fibrosis, gastroesophageal reflux or HIV and other immune system related diseases that can results in nasal blockage.
- Respiratory tract infections: Infections in the respiratory tract are mostly common colds that can inflame and thicken the sinus membranes and thereby block mucus drainage. These infections can be viral, bacterial or fungal.
- Allergies : Allergies such as hay fever. The Inflammation which occurs with the allergies can block the sinuses.
- A nasal passage abnormality, such as a deviated nasal septum or nasal polyps
- Asthma, which is highly connected to chronic sinusitis
- Aspirin sensitivity that causes respiratory symptoms
- An immune system disorder, such as HIV/AIDS or cystic fibrosis
- Hay fever or another allergic condition that also affects sinuses
Chronic sinusitis complications include:
- Meningitis: This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.
- Other infections: Uncommonly, infection can spread to the bones (osteomyelitis) or skin (cellulitis).
- Partial or the complete loss of sense of smell: Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell.
- Vision problems: If the infection spreads to the eye socket, it can cause reduced vision or even blindness, which may be permanent.
Your doctor will feel for tenderness in your nose and face and look inside your nose.
Other methods for diagnosing chronic sinusitis include:
- Nasal endoscopy: A thin flexible tube (endoscope) with a fiber-optic light is inserted through the nose that allows the doctor to see the inside of the sinuses. This is also known as rhinoscopy.
- Imaging studies: Images taken using a CT scan or MRI can show details of your sinuses and nasal area. These might be the pinpoint of a deep inflammation or the physical obstruction is difficult to detect by using an endoscope.
- Nasal and sinus cultures: Cultures are generally unnecessary for diagnosing chronic sinusitis. However, when the condition fails to respond to treatments or is worsening, tissue cultures might help determine the cause, such as bacteria or fungi.