Last Updated on October 31, 2025 by Saadet Demir
A comprehensive guide to chronic sinusitis treatment, including steroid sprays, biologics, and functional endoscopic sinus surgery (FESS).
Do you have constant nasal congestion, facial pressure, or a reduced sense of smell? These symptoms might be from chronic rhinosinusitis. This condition affects millions of people worldwide.
At Liv Hospital, we know how chronic sinusitis can ruin your life. Chronic sinusitis means your nose and sinuses are always inflamed. It lasts for at least 3 months and can cause nasal drainage and blockage.
Our guide covers diagnosing and treating chronic rhinosinusitis. We talk about its definition, symptoms, and how to treat it. We aim to give you the best medical care with the latest methods and focus on you.
Chronic rhinosinusitis is often not well understood. It’s important to look closely at its definition and how it’s diagnosed. This ensures the right treatment is given.
Chronic rhinosinusitis is a long-term condition of the sinuses. It lasts for at least 12 weeks. Symptoms include nasal congestion, discharge, facial pain, or a decrease in smell.
Doctors use tests like endoscopy or CT scans to confirm it. Getting a correct diagnosis is essential for treatment. The criteria for diagnosis are:
Symptoms | Objective Findings |
Nasal congestion, nasal discharge, facial pain, reduction in smell | Endoscopy or CT scans showing sinonasal inflammation |
Chronic sinusitis and chronic rhinosinusitis are not the same. Chronic sinusitis is inflammation of the sinuses. Chronic rhinosinusitis affects both the nasal passages and sinuses.
The main difference is where the inflammation happens and the symptoms. Knowing this helps doctors treat the right area.
Condition | Areas Affected | Symptoms |
Chronic Sinusitis | Sinuses | Facial pain, headache |
Chronic Rhinosinusitis | Nasal passages and sinuses | Nasal congestion, discharge, facial pain, reduction in smell |
Understanding these differences helps doctors give better care. This leads to better health outcomes for patients.
Understanding chronic rhinosinusitis is key to better treatments. It’s a big health problem worldwide, affecting many people.
Studies show that 2.1% to 15% of people have it, with more women than men. The wide range shows how different places and people can be affected differently.
Studies have shown how big a problem chronic rhinosinusitis is. It’s more common in some areas and among certain groups. This makes it important to focus on these groups in public health efforts.
It costs a lot in healthcare, leads to lost work time, and lowers quality of life. Knowing these facts helps us use resources better and improve care for patients.
There are many things that can increase your risk of getting chronic rhinosinusitis. These include:
Knowing these risk factors helps doctors catch and treat chronic rhinosinusitis early. This can make symptoms less severe and improve how patients feel.
Chronic rhinosinusitis symptoms can really affect a person’s life. This condition causes ongoing issues in the nasal passages and sinuses. It leads to many complications.
The main symptoms of chronic rhinosinusitis are:
These symptoms can really change a person’s life. Chronic rhinosinusitis can cause:
Chronic rhinosinusitis can really affect how well you live your life. Here’s a table showing how it can impact daily activities:
Symptom | Impact on Daily Life | Potential Consequences |
Nasal Congestion | Difficulty breathing, sleep disturbances | Fatigue, reduced productivity |
Nasal Discharge | Frequent need to blow nose, discomfort | Social embarrassment, reduced quality of life |
Altered Sense of Smell | Reduced ability to enjoy food, detect danger (e.g., gas leaks) | Nutritional deficiencies, safety risks |
Facial Pain or Pressure | Discomfort, pain affecting daily activities | Reduced productivity, emotional distress |
It’s important to understand these symptoms and how they affect your life. This helps doctors create better treatment plans. By focusing on the symptoms and their effects, doctors can give better care to those with chronic rhinosinusitis.
Chronic rhinosinusitis is a complex condition. It can be categorized into two types based on the presence or absence of nasal polyps. This classification helps determine the right treatment and understand the patient’s prognosis.
Chronic rhinosinusitis with nasal polyps (CRSwNP) has benign growths in the nasal passages. These polyps can cause symptoms like nasal congestion, loss of smell, and facial pain.
Nasal polyps often mean more severe inflammation. They also increase the need for surgery. Treatment for CRSwNP includes medical therapies like corticosteroids and possibly surgery to remove the polyps.
Key characteristics of CRSwNP include:
Chronic rhinosinusitis without nasal polyps (CRSsNP) is diagnosed when patients have symptoms without polyps. This type often has localized inflammation and different causes than CRSwNP.
Treatment for CRSsNP aims to manage inflammation and symptoms. It includes nasal saline irrigation and intranasal corticosteroids.
Key features of CRSsNP include:
Understanding the differences between these two types is key. It helps healthcare providers tailor treatments to each patient’s needs.
Diagnosing chronic rhinosinusitis involves several steps. We start with a detailed physical exam. Then, we use nasal endoscopy and imaging studies to make treatment plans. A diagnosis needs both clinical checks and findings from endoscopy or CT scans.
The first step is a thorough physical exam. We look at the patient’s medical history and check the nasal passages and sinuses. This helps spot any issues or inflammation.
Nasal endoscopy is key. It lets us see inside the nasal cavity and sinuses. We can spot nasal polyps, discharge, and other signs of chronic rhinosinusitis.
Nasal endoscopy uses a flexible or rigid endoscope. It gives us a close look at the nasal passages and sinuses. This is important for seeing how bad the disease is and deciding on treatment.
Imaging studies, like CT scans, are also important. They show us the sinuses in detail. This helps us see how much inflammation there is and any structural problems.
By combining physical exams, nasal endoscopy, and imaging, we can accurately diagnose chronic rhinosinusitis. Then, we can create a treatment plan that fits the patient’s needs.
Managing chronic rhinosinusitis starts with knowing the best first treatments. We’ll look at the main steps doctors suggest for this condition.
Nasal saline irrigation is a simple yet effective way to clear nasal passages and sinuses. It involves rinsing the nasal cavity with a saline solution. This helps remove debris, reduce inflammation, and improve drainage.
Benefits of Nasal Saline Irrigation: It helps reduce nasal congestion, improves sinus drainage, and aids in healing the nasal mucosa.
Intranasal corticosteroid sprays are key in treating chronic rhinosinusitis. These sprays reduce inflammation in the nasal passages and sinuses. This helps ease symptoms like congestion and nasal discharge.
It’s important to use these sprays as directed to avoid side effects.
Treatment | Mechanism of Action | Benefits | Potential Side Effects |
Nasal Saline Irrigation | Clears nasal passages and sinuses by rinsing with saline solution | Reduces debris, inflammation, and improves drainage | Nasal irritation, dryness |
Intranasal Corticosteroid Sprays | Reduces inflammation within nasal passages and sinuses | Alleviates congestion, nasal discharge, and other symptoms | Nasal dryness, irritation, possible systemic effects with long-term use |
Using nasal saline irrigation and intranasal corticosteroid sprays together can greatly help patients with chronic rhinosinusitis. It’s vital to talk to a healthcare provider to find the right treatment plan.
When first-line treatments for chronic rhinosinusitis don’t work, advanced treatments are needed. These options help those with severe symptoms or who didn’t get better with initial treatments. They can bring a lot of relief.
Oral corticosteroids are used for short periods to fight severe inflammation from nasal polyps. A study shows they can greatly improve symptoms. But, we use them carefully because of possible side effects with long-term use.
Key benefits of oral corticosteroids include:
Antibiotics are used for chronic rhinosinusitis, mainly when a bacterial infection is suspected. We only use antibiotics when there’s clear evidence of a bacterial infection.
It’s important to tell the difference between bacterial and non-bacterial causes to avoid overusing antibiotics. The choice of antibiotic should be based on culture results when available.
Biologic therapies are a new hope for treating severe chronic rhinosinusitis with nasal polyps. They target specific inflammation pathways, providing a more precise treatment.
“Biologic therapies are revolutionizing the management of severe chronic rhinosinusitis by providing targeted treatment options that can significantly improve patient outcomes.”
There’s growing evidence that biologics can reduce nasal polyp size, improve symptoms, and lower the need for surgery and systemic corticosteroids.
When medical treatments don’t work, surgery is often the next step for chronic rhinosinusitis. “Surgery is often a turning point in the management of this condition, providing relief when other treatments have failed,” say experts.
Surgery is considered when chronic rhinosinusitis symptoms last despite the best medical care. This includes cases with nasal polyps or significant sinus blockage. We decide on surgery based on symptom severity and how it affects daily life.
The most common surgery for chronic rhinosinusitis is endoscopic sinus surgery. This uses an endoscope to see inside the sinuses and remove blockages.
Other procedures might include septoplasty for a deviated septum or turbinoplasty to shrink turbinate bones. The right procedure depends on the patient’s specific needs and disease extent.
Good post-surgical care is key for the best results. This includes nasal saline irrigation to clean the sinuses and promote healing. We also schedule follow-ups to check on recovery and remove any blockages.
“Proper post-operative care can significantly impact the success of sinus surgery, reducing the risk of complications and improving long-term results.”
By combining surgery with thorough post-care, we can greatly improve symptoms and life quality for those with chronic rhinosinusitis.
Changing your lifestyle can greatly improve life with chronic rhinosinusitis. Making smart choices can lessen symptoms and boost well-being. We’ll look at important lifestyle changes that can help a lot.
Managing your environment is key in fighting chronic rhinosinusitis. Stay away from allergens, pollutants, and irritants. Clean homes and air purifiers can cut down on symptoms.
Key environmental controls include:
Your diet is very important in managing chronic rhinosinusitis. Some foods can make symptoms worse, while others can help. Eating lots of fruits, veggies, and omega-3s is good.
Beneficial dietary changes may include:
“A healthy diet is not just about avoiding certain foods, but also about incorporating nutrients that can help reduce inflammation and promote healing.”
Stress can really affect chronic rhinosinusitis symptoms. Doing things that reduce stress can help manage the condition. Meditation, yoga, and deep breathing are good options.
Effective stress management techniques include:
Creating a good treatment plan for chronic rhinosinusitis needs a full approach. This includes medical treatments, lifestyle changes, and sometimes surgery. Knowing about the condition and its treatments helps people work with their doctors to make a plan that fits them.
A treatment plan should match the person’s needs. It should consider how bad the symptoms are, if there are nasal polyps, and how well past treatments worked. This way, people can handle their symptoms better and live a better life.
It’s key for patients and doctors to work together on a treatment plan. This teamwork helps people manage chronic rhinosinusitis well. It also makes it easier to deal with the condition every day.
Chronic rhinosinusitis is a long-term condition. It causes inflammation and infection in the nasal passages and sinuses. This lasts for 12 weeks or more.
Symptoms include nasal congestion and facial pain or pressure. You might also lose your sense of smell and have thick nasal discharge.
Doctors use a physical exam, nasal endoscopy, and CT scans. These help see how much the sinuses are inflamed and if there are any problems.
Chronic sinusitis is just inflammation of the sinuses. Chronic rhinosinusitis affects both the nasal passages and sinuses. It’s a more complete condition.
First, doctors might use nasal saline irrigation and intranasal corticosteroid sprays. These help reduce inflammation and improve symptoms.
Antibiotics are used when there’s a bacterial infection. The type of antibiotic depends on the bacteria causing the infection.
Biologic therapies are for severe cases. They target specific inflammation mechanisms, helping those with nasal polyps.
Surgery is needed when medical treatments don’t work. It’s for those with big problems like nasal polyps blocking the sinuses.
Changes include avoiding allergens and irritants. Eating well and managing stress also help. These can reduce symptoms.
Chronic rhinosinusitis is not curable, but it can be managed. Treatment and lifestyle changes can improve symptoms and quality of life. This lets people live active lives.
National Center for Biotechnology Information. (2025). How to Treat Chronic Rhinosinusitis A Complete Guide. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601443/).