Sinusitis (Rhinosinusitis)

The pain experienced with sinusitis is usually caused by a blockage of the sinus opening, which could be caused by infections, irritants, allergies, or a structural abnormality.

Infections

Adults can suffer from a cold or upper respiratory tract infection up to 3 times a year, with children getting them more regularly. Following a cold, when mucus turns yellow or green as opposed to clear, it's a sign of a bacterial infection, which, in addition to a viral infection, can cause swelling of the lining of the nose and thickening of the normal mucus. Sinus infection may occur as a result of this, as it inhibits proper sinus drainage.

Irritants

Swelling of the lining of the nose can also be caused by irritants like air pollution, smoke and chemicals (some sprays containing pesticides, for example), disinfectants, and household detergents. Again, this can impair sinus drainage by narrowing or blocking the opening to the sinuses and, in turn, causes infection.

Allergies

Allergies can cause inflammation inside the nose, as common symptoms of an allergic reaction include nasal stuffiness, a runny nose, sneezing, and itchy watery eyes. Chronic sinusitis is sometimes associated with asthma, and allergies are responsible for asthma in some patients. The nasal stuffiness experienced with allergies makes asthma more difficult to control.

Structural abnormality

Narrowing of the nasal cavity can sometimes be caused by structural problems as a result of trauma, or it can develop when growing. If the narrowing is severe, then it causes a blockage with mucus building up behind it, leading to infection.

At Welbeck, our ear, nose and throat (ENT) specialists can make a diagnosis of sinusitis by performing a physical examination, taking a medical history, and examining your nasal lining and sinus openings with a nasal endoscopy.

This simple diagnostic procedure involves inserting a small tube with a camera on the end (endoscope) into your nose. Images will appear on a screen where your consultant will be able to see your sinuses and identify any inflammation and infection. In addition, a cone beam CT scan can reveal inflammation or blockages within the sinus cavities and could be another way that sinusitis is discovered.

If you're affected by postnasal drip, your throat may be checked. Similarly, your ears can be checked in case there is congestion or fluid accumulation.

To confirm whether or not your sinusitis is caused by allergens, allergy testing will also often be performed. This can either be via a skin prick test — where small amounts of allergens are introduced to the skin and any sensitivities or reactions are analysed — or an allergen-specific blood test, where a sample is analysed for allergen-specific antibodies.

While it isn’t always possible to prevent sinusitis completely, there are several steps you can take to reduce your risk or prevent flare-ups:

• wash your hands regularly to prevent the spread of cold and flu viruses

• manage allergies effectively with antihistamines or nasal sprays (as recommended by your doctor)

• avoid cigarette smoke and other irritants

• use a humidifier at home if your air is dry

• stay hydrated to help thin mucus

• avoid overusing nasal decongestant sprays (use for no more than 5 to 7 days)

• consider saline nasal rinses to keep your nasal passages clear

If you’re prone to sinusitis, seeing a specialist early can help identify underlying issues such as nasal polyps or a deviated septum that may make infections more likely.

Most people recover from sinusitis without problems. However, if left untreated or if it becomes chronic, sinusitis can occasionally cause complications. These include:

• chronic sinus infections that last for months or keep returning

• spread of infection to nearby areas such as the eyes or bones (rare)

• reduced sense of smell or taste

• sleep problems due to constant congestion

• asthma flare-ups in people who have both conditions

Serious complications are rare, but if you develop swelling around your eyes, a severe headache, a high fever, or vision problems, seek medical help immediately.

Acute sinusitis is treated with antibiotics and medication to reduce swelling in the lining of the nose, such as decongestants.

Chronic sinusitis may need longer-term treatment such as antibiotics, decongestants and nasal steroid sprays. Antihistamines may be useful for patients with an allergy.

Most cases of sinusitis will be managed effectively with medications, but in those that are not, surgery may be considered. Several surgical options are available, including endoscopic sinus surgery (ESS). Most surgical options are minimally invasive so do not require making cuts to the skin surrounding the nose. 

At Welbeck, we also offer an innovative treatment called ClariFix. ClariFix permanently reduces symptoms of chronic rhinitis with cryotherapy and is advised if other lines of treatment haven’t worked.

We perform ClariFix as an outpatient procedure. It involves placing a small amount of liquid nitrogen into the back of your nose. The treatment takes around half an hour, and you can return to regular activities right away.

Your consultant will discuss which treatment option is most appropriate based on the severity of your symptoms.

How long does sinusitis usually last?

Acute sinusitis often improves within 2 to 3 weeks, even without antibiotics. Chronic sinusitis can last for 12 weeks or longer and may need specialist treatment to prevent flare-ups.

When should I see a doctor for sinusitis?

If your symptoms last longer than 10 days, worsen after improving, or you experience severe pain, swelling around your eyes, or a high temperature, you should book an appointment with an ENT specialist.

What’s the difference between sinusitis and a common cold?

A cold usually clears up within a week and is caused by a virus. Sinusitis lasts longer and often causes facial pain, pressure, and thicker nasal discharge.

Can sinusitis come back after treatment?

Yes. Chronic sinusitis or untreated allergies can cause recurring symptoms. Identifying the underlying cause, such as nasal polyps or structural issues, greatly reduces the risk of recurrence.