Chronic Sinusitis – Diagnosis and Treatment
Diagnosis
Doctors usually start with a physical exam when they suspect sinusitis or a sinus infection. They look for things like nasal blockage, headache, facial pain, or nasal discharge.
Providers press around your nose and face to check for tenderness. They’ll often use a light to peek inside your nasal cavity.
Diagnostic Steps:
Nasal Endoscopy: The doctor uses a thin, flexible tube with a light—an endoscope—and puts it in your nose. This lets them see inside your nasal passages and spot polyps, inflammation, or blocked sinus openings.
Imaging: CT or MRI scans show detailed images of the paranasal sinuses. Doctors use these to find chronic sinusitis, a deviated septum, or nasal polyps, and to figure out which sinuses (frontal, sphenoid, ethmoid, or maxillary) are involved.
Lab Tests: If standard treatments aren’t helping, your provider might take a culture from your nose or sinuses. This can check for bacteria, fungi, or severe inflammation.
Allergy Testing:
Sometimes, doctors run allergy tests to see if allergies are behind your symptoms.
Doctors rely on both what you tell them and what they find in tests to figure out what’s going on and decide how to treat it.
Treatment
Medications for Bacterial Infections
Antibiotics can help if a bacterial infection is causing your sinus symptoms. If your provider thinks bacteria are the main culprit, they might prescribe a penicillin-class antibiotic or a tetracycline antibiotic.
| Medication | Usual Use |
|---|---|
| Penicillin-type antibiotic | First-line choice |
| Tetracycline antibiotic | Used if allergic or resistant cases |
These antibiotics target the infection directly. Not every sinus infection needs antibiotics, though, since viruses or allergies often cause them. Usually, you’ll get a short course if other treatments haven’t worked or if your symptoms are severe and stubborn.
Doctors always ask patients to finish their full course of antibiotics, even if they start feeling better fast. If you stop early, the infection might come back.
Allergy Shots and Immune Treatments
If allergies make your sinus symptoms worse, immunotherapy can help. These allergy shots aim to reduce your body’s reaction to allergens over time.
With regular shots, some people with chronic sinus issues notice fewer symptoms. Immunotherapy works well for folks who don’t get relief from nasal sprays or pills.
Doctors sometimes use newer immune-based injections, especially if you have nasal polyps and regular medicine isn’t working. These shots target specific immune pathways, helping shrink polyps and lower swelling.
Advanced Procedures for Sinus Relief
If standard treatments don’t help your chronic sinusitis, surgery might be the next step. Endoscopic sinus surgery uses a thin tube with a light—an endoscope—and small tools to remove tissue or open blocked passages.
Doctors recommend surgery if you have nasal polyps, ongoing blockages, or a deviated septum behind your symptoms. This procedure opens up the sinuses and allows better drainage, which can make breathing easier and ease long-term symptoms.
Most people recover quickly and get back to normal activities within a week.
Lifestyle and Home Remedies
Managing symptoms at home can make a real difference for people dealing with sinus issues like congestion, cough, or a runny nose.
Simple steps can help:
- Nasal Irrigation: Use saline washes or a neti pot to clear your nasal passages and ease stuffiness.
- Steam Inhalation: Breathe in steam from hot water or take a warm shower to thin mucus and reduce sinus pressure.
- Hydration: Drink plenty of water to keep mucus thin and your throat moist, which helps with sore throat and cough.
- Avoid irritants: Stay away from tobacco smoke and secondhand smoke to lower rhinitis, bad breath, and allergic reactions.
Resting, using decongestant or corticosteroid nasal sprays (if your provider recommends them), and keeping your head elevated can also make you more comfortable when you’re dealing with cold symptoms or allergic rhinitis.
Getting Ready for Your Visit
A little prep before your appointment goes a long way. Write down a list of your symptoms and when they started, even if some don’t seem related to your sinus or allergy troubles.
Include any past or current conditions, like allergies or asthma, since these can affect your diagnosis or treatment.
Jot down all the medications, vitamins, and supplements you use, along with the dosages. This helps your provider see the full picture and avoid treatment conflicts.
You might want to organize your questions for the doctor. Some things to ask about:
- Possible causes of your symptoms
- What tests you might need
- Whether your symptoms could stick around
- Tips for managing conditions together, especially if you have allergies
- If you should see an otolaryngologist or allergist
- Good sources like brochures or websites for more info
- Treatment options for your case
Bring this info with you to your appointment so you don’t forget anything you want to discuss.
What the Provider Will Likely Ask About
When you show up for the visit, the provider will probably ask a bunch of questions to figure out what’s really going on. They’ll want to know if your symptoms stick around all the time or just pop up now and then.
Expect them to check how bad your symptoms feel and what, if anything, seems to make things better or worse.
They’ll also ask about your exposure to smoke or any pollutants. Oh, and don’t be surprised if they dig into your family’s allergy history too.
If you can, try to be honest and specific—especially about allergy symptoms or any sinus issues. That really helps them make a good diagnosis and get you on the right care plan.
