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Sinusitis affects about one in eight adults each year. For many, the inflammation starts during a cold, when viruses or bacteria infect their sinuses, causing the lining to swell and block the drainage channels. To treat sinusitis, the first stage is to diagnose the cause of the infection or inflammation.

What type of sinusitis do I have?

The two principal types of sinusitis are acute and chronic. Acute sinusitis is caused by either viruses or bacteria. If you’ve been sick for less than 10 days and the symptoms are not worsening, you likely have acute viral sinusitis, but if you don’t improve within 10 days, or appear to improve before getting worse again, you probably have acute bacterial sinusitis.

Chronic sinusitis is different. Typically, it has more to do with prolonged inflammation than infection and is identified by symptoms that last longer than 12 weeks.

It is not always easy to self-diagnose, so consulting an ENT doctor is highly recommended if any of these symptoms persist for more than 10 days:

  • cloudy or coloured drainage from your nose for up to four weeks
  • Stuffy, congested, or blocked nose
  • Pain, pressure, or fullness in the face, head, or around the eyes
  • Long-lasting cold symptoms
  • Polyps (growths in the nose)
  • Thickened mucus
  • Pus in the sinuses
  • Loss of smell.

An ENT specialist will be able to diagnose the cause of your sinusitis, and if necessary, can order a CT scan. Once the diagnosis is complete, treatment can begin.

How is acute sinusitis treated?

Most cases of acute sinusitis are viral rather than bacterial, which means antibiotics tend to be ineffective. Anti-inflammatories such as ibuprofen can be of use, as can steroid sprays, or saltwater irrigation of the nose.

These treatments are also good options for acute bacterial sinusitis. Most people get better naturally from acute bacterial sinusitis, but unlike viral sinusitis, some patients with bacterial sinusitis recover more quickly with an antibiotic.

How is chronic sinusitis treated?

Saltwater nasal irrigation and/or steroid sprays are the go-to treatments for the symptoms of chronic sinusitis. With chronic sinusitis, treatment aims first and foremost to reduce and control inflammation.

What if these treatments don’t work?

If the treatments described above are ineffective, sinus surgery may be required. Sinus surgery is minimally invasive and can target polyps while opening the pathways to help with breathing. It is ideal for those with repeat sinus infections.

What does sinus surgery involve?

Sinus surgery involves the removal of small pieces of bone, tissue, membranes, or growths. The most common type of surgery is called endoscopic sinus surgery, in which a narrow scope is used to see inside the nose and sinuses, to guide the surgeon. The surgery widens the natural drainage channels between the sinuses and the nose, allowing mucus out and air in.

There is a newer treatment option called balloon sinus ostial dilation (BSOD), which relies on widening the sinus openings rather than removing bone and tissue. Balloon dilation may not be appropriate for all patients – if in doubt, ask your ENT specialist!

The next step

If you think you might have nose or sinus problems, get in touch with our ENT specialist at our Harley Street clinic in London to book an ENT specialist consultation. Call 020 3897 0667, visit our contact page or email secretary.jonathanhughes@kmsprofessionals.co.uk