If you're dealing with facial pressure, a constantly stuffy nose, and fatigue that has lasted for months, you may be experiencing chronic rhinosinusitis. Unlike an acute sinus infection that resolves in a few weeks, chronic rhinosinusitis is a persistent inflammation of the sinus passages lasting for 12 weeks or more, despite treatment attempts.
The constant discomfort can significantly impact your quality of life, but it’s important to know that effective treatments are available. The goal of treatment is to reduce inflammation, improve sinus drainage, and address the underlying cause of the problem.
Here’s a look at the common approaches to treating chronic rhinosinusitis, often used in combination.
1. Medical Management and At-Home Care
For most patients, treatment begins with non-surgical methods. A personalized plan may include:
Nasal Corticosteroid Sprays: These prescription sprays are a cornerstone of treatment. They safely and effectively reduce the inflammation in your nasal passages and sinuses, helping to relieve stuffiness and pressure.
Saline Nasal Irrigation: Using a saline solution with squeeze bottle helps to rinse away mucus, allergens, and irritants from your sinuses. This simple daily practice can significantly improve symptoms.
Antibiotics: If your doctor suspects a bacterial infection is contributing to your chronic condition, a targeted course of antibiotics may be prescribed. However, since chronic rhinosinusitisis primarily an inflammatory issue, antibiotics are not always the answer.
Allergy Management: If allergies are triggering your sinus inflammation, treating them with antihistamines, allergy shots (immunotherapy), or avoiding triggers is crucial for long-term relief.
Oral Corticosteroids: In cases of severe inflammation or nasal polyps, a short course of oral steroid pills may be prescribed to dramatically reduce swelling.
2. In-Office Procedures
When medications aren't providing enough relief, a minimally invasive procedure may be recommended.
Balloon Sinuplasty: This procedure is performed in the doctor's office, often under local anesthesia. A tiny, flexible balloon catheter is inserted into the blocked sinus passage and gently inflated to widen the opening. The balloon is then deflated and removed, leaving the passage open to allow for proper drainage. Recovery is typically very quick. Beware that this procedure only help clearing out blocked mucous or pus. The instrument is one-time use and expensive.
3. Sinus Surgery
For patients with significant blockages from nasal polyps, scar tissue, or a deviated septum, surgery may be the most effective long-term solution.
Functional Endoscopic Sinus Surgery (FESS): FESS is the modern standard for sinus surgery. An Ear, Nose, and Throat (ENT) doctors uses a thin, lighted camera called an endoscope to see inside your nose and sinuses. Using micro-instruments, the surgeon removes the blockages (like polyps or thin bone partitions) and enlarges the natural drainage pathways of the sinuses. There are no external incisions, and the goal is to restore the natural function of your sinuses. Also this is considered a "reset" or "starting point" for long term steroid irrigations.
Your Path to Breathing Better
Living with chronic sinusitis can be draining, but you don't have to endure the symptoms forever. The right treatment plan is highly personal and depends on the specific cause of your condition.
The first step is a thorough evaluation by an ENT specialist. A proper diagnosis, which may include a nasal endoscopy or a CT scan, is key to developing a treatment strategy that will finally bring you relief.
Assistant Prof. Wirach Chitsuthipakorn