How Long Does Sinusitis Last?

Sinuses are air-filled cavities in the skull that surround the nose. They are present in the forehead, cheeks, and near the eyes. These are closed spaces in the skull with a small opening. Sinus infection (sinusitis) occurs when the opening gets blocked and mucus gets trapped in the sinuses and starts accumulating. This causes viruses, bacteria, or fungi to grow easily because of the moist and stagnant environment. This is also called acute sinusitis.

Chronic sinusitis occurs when the tissue lining and spaces get inflamed for three months or longer. Chronic sinusitis usually involves nasal airway inflammation (rhinitis) as well. Hence, it is also called chronic rhinosinusitis (CRS). Chronic sinusitis usually occurs as a result of recurrent episodes of acute sinusitis that haven’t been managed appropriately. CRS is typically noninfective and occurs mainly due to allergy or medical conditions such as cystic fibrosis, where mucus clearance is impaired. In CRS, normal mucus drainage is impaired, and there is inflammation and swelling of the tissues in the nose and sinuses causing nasal discharge and obstruction.

Symptoms of a sinus infection include:

• Nasal obstruction
• Postnasal drip (dripping of the mucus from the nose to throat) when the person is lying down
• Headache
• Facial pain
• Cough
• Fever
• Fatigue
• Halitosis (bad breath)
• Pain over the upper teeth

Common signs and symptoms of chronic sinusitis include:

• Itching of the nose
• Thick white or yellowish-white (yellowish discharge indicates superimposed bacterial infection) discharge from the nose
• Postnasal drip (constant drainage of the mucus through the back of the nose and down the throat) causing discomfort and throat irritation
• Nasal obstruction (nose block) or congestion
• Pain, tenderness, and swelling around your eyes, cheeks, nose, or forehead
• Reduced sense of smell and taste
• Change in voice
• Pain in the upper jaw and teeth, especially around the canines 
• Cough
• Recurrent clearing of the throat 
• Recurrent episodes of a sore throat because of mouth breathing as a result of nose block and postnasal drip
• Halitosis (Bad breath)
• Disturbed sleep
• Inability to concentrate 
• Fatigue

Treatment options include:

Medical treatment:

• Over-the-counter medication such as paracetamol or ibuprofen can help relieve symptoms such as pain and fever.
• Nasal decongestant sprays such as oxymetazoline can reduce swelling and congestion, relieving the nasal obstruction.
• Antibiotics may be prescribed to get rid of the infection faster.

Supportive treatment:

• Humidifiers to add moisture to the air that reduces dryness, softening the dried mucus
• Nasal irrigation
• Nasal irrigation with saline using products such as a neti pot that can flush out excess mucus, bacteria, and crusts, reducing nasal congestion
• Steam inhalation that can moisten the dried mucus and crusts, reducing nasal congestion
• Adequate rest and hydration
• Applying a warm compress over the face that can help reduce the pain and nasal congestion

Treatment options for chronic sinusitis include:

• Corticosteroids: Corticosteroids may be prescribed in the form of local nasal sprays or oral medications or as injections. Steroids help to suppress allergy, reduce inflammation, and shrink tissue growth. Examples include fluticasone, mometasone, and beclomethasone.
• Saline nasal irrigation: The nose may be irrigated with nasal sprays or solutions. This helps to clear the airway by flushing out mucus, crusts, and pollutants.
• Aspirin desensitization treatment: Those who have allergic reactions to aspirin causing sinusitis can be treated by administering increasing doses of aspirin under a doctor’s supervision until aspirin tolerance increases.
• Antibiotics: Chronic rhinosinusitis (CRS) is typically not infective. However, antibiotics may be used to treat secondary bacterial infections. The role of antibiotics is to get rid of a biofilm (a thin layer of fluid containing germs) that lines the sinus lining.
• Immunotherapy: CRS be treated with immunotherapy. Dupilumab is one such drug that can help suppress the body's immune cells to reduce reaction to specific allergens.
• Polyps: Polyps around the sinus openings may cause obstruction of the sinuses. These need to be managed by medicines or surgery.
• Surgery: An endoscopic sinus surgery may be done in patients resistant to medical treatment or medication. An endoscope (a thin, tube with an attached light and camera) and surgical instruments and inserted into the nose to perform surgery under anesthesia.