Chronic sinusitis

This occurs when individuals experience sinus infection symptoms for more than twelve weeks. In the same way as acute sinusitis, the nasal lining is also affected and hence chronic sinusitis is also called chronic rhinosinusitis with the 'rhino' part referring to the nose. In some individuals, as well as inflammation, nasal polyps may also develop. A nasal polyp is simply a benign swelling coming from the lining of the nose due to changes in the body's immune system.

We think that it may be triggered by an initial episode of acute sinusitis but researchers are still looking into the biological mechanisms of how this happens. Dr Michael, in collaboration with University of Melbourne, is currently conducting a study researching into one of these mechanisms.

Chronic sinusitis has been estimated to affect between 5-15% of the population and can be an extremely debilitating condition. In fact, several studies have identified how great the affect is upon individuals. It is responsible for a significant economic burden on individuals and the country as it affects or prevents people’s ability to work with a loss of income worse than sufferers of diabetes, severe asthma or chronic migraines.

Further, it has been shown to be as causing an impact on the people which is comparable to severe heart and kidney disease.

What problems can chronic sinus infection?

Chronic sinusitis can be an extremely debilitating condition.

It can cause nasal blockage (especially in those with nasal polyps), facial pain ('sinus headaches'), nasal congestion, loss of smell or sensing a bad smell and a runny nose. It can also negatively affect how you feel. Individuals may feel lethargic, unhappy or embarrassed and have difficulties concentrating.

Sometimes, inflammation can pass to surrounding structures and cause serious complications which may affect your vision, teeth, nerves and blood vessels that lie far back in the nose.

What chronic sinus infection treatment is usually done?

In your consultation with Dr. Michael, you will be asked questions in relation to sinus symptoms that you may be having with your nose. You will also have an endoscopy. This is a specialised examination where a fine camera (endoscope) is used to inspect the inside of the nasal passageways to look for signs of chronic sinus infection or nasal polyps. Other tests such as investigating for allergies or specialised scans may also be arranged. More complex cases may need a further level of scans which compliment specialised equipment, termed image-guidance, that Dr Michael uses when operating in Melbourne. You will be asked to complete questionnaires which provide a guide to the issues that you have.

The mainstay of sinus infection treatment for chronic sinus infection  is medical. This is in the form of using salt water washes (nasal douche) to irrigate the nose and varying strengths of steroid medicines. These may take the form of tablets, drops or nasal sprays dependent upon the severity of your condition.

If medical sinus infection treatment is unsuccessful and your examination and scan investigations support that you have sinus disease, sinusitis surgery may be suggested. This sinus operation is termed functional endoscopic sinus surgery (FESS). This operation is used to treat people with chronic sinusitis with or without the presence of nasal polyps.