Sinusitis is inflammation of the sinuses. There are two basic types of sinusitis: acute sinusitis and chronic sinusitis. Acute sinusitis is a sinus infection that lasts less than four weeks. Chronic sinusitis is a sinus infection or sinus inflammation that lasts more than 12 weeks. Both have the same symptoms.
Symptoms of sinusitis include trouble breathing through the nose, runny nose, drainage in the throat, face pain or pressure and trouble smelling. Based on the symptoms, it is hard to know what is causing them. This is why visiting with your ENT doctor is so important. Your ENT may perform a nasal endoscopy – a procedure that uses a camera to look at the inside of your nose where your sinuses drain – in the clinic to check your nose and sinus cavities. In fact, your ENT may be able to take a sample during your nasal endoscopy for lab testing. This helps identify your problem and plan your treatment.
Acute sinusitis does not always need to be treated with antibiotics. Often, saline irrigations (similar to a Neti-pot) and some nasal sprays can provide enough relief until the infection clears. If further treatment is needed, it is common to use antibiotics or steroids. If your ENT takes a sample, antibiotics specifically directed toward the bacteria collected can be prescribed. A CT scan is not usually required. If your sinus infections keep coming back, your ENT may recommend balloon sinuplasty or sinus surgery. The goal is to reduce the frequency or the severity of your infections.
Chronic sinusitis can often be treated medically. Medical treatment always includes saline irrigations with nasal steroid sprays. The treatment often includes either a long course of antibiotics or a steroid taper. Many patients have their symptoms resolved with this therapy.
Unfortunately, some patients continue to have symptoms. If so, a CT scan may be needed to evaluate the extent of sinus disease after treatment. In these cases, balloon sinuplasty or sinus surgery is often recommended. Only certain patients truly benefit from balloon sinuplasty, and many benefit more from sinus surgery. It is very important you visit with your ENT to decide which treatment would be best in your case.