Chronic sinusitis is a persistent sinus infection lasting anywhere from 12 weeks to years or one that recurs more than twice within one year. Chronic sinusitis is also called chronic rhinosinusitis and is characterized by the inflammation or swelling of the sinuses, which are the air-filled spaces tucked within your skull among your facial bones.
Because your sinuses are located in close proximity to your nose, anything causing nasal obstruction can also plug up your sinuses. Inflammation or swelling of the mucous lining in the nasal and paranasal passageways is a major cause of obstruction. Continual inflammation can thicken the mucous lining over time and trigger the development of nasal polyps or growths in the openings of your sinuses or nose. Nasal polyps can make nasal breathing difficult and can also increase obstruction even more. Because nasal polyps are so commonly seen with chronic sinusitis, physicians will frequently note their presence in a diagnosis.
Whereas acute sinusitis develops rapidly and resolves within weeks of treatment, chronic sinusitis can feel very permanent. It often accompanies other chronic conditions, which may be responsible for triggering the inflammatory responses, such as:
Asthma is a chronic inflammatory disease that affects the reactivity and diameter of your airways. Asthma and allergies often coexist and mutually affect each other. Keeping these conditions under control by regularly taking your daily prescribed medications or getting allergy shots will help to prevent the symptoms that may cause secondary illnesses such as chronic sinusitis. Avoiding environmental triggers such as dust, mold, and pet dander may help prevent an inflammatory cycle from occurring.
Anatomical or Structural Conditions
Structural blockages that narrow the openings of the sinuses and restrict their ability to pass mucous through can cause chronic sinusitis. Nasal polyps, previously mentioned, or a deviated septum, the mucous wall separating the nostrils, can cause nasal and sinus occlusion or blockage. Additionally, broken facial bones and scar tissue may cause anatomical shifting and inhibit mucous clearance. Surgery may be necessary to remove obstructions or at least enlarge the openings once again.
Many researchers believe that the overgrowth of fungus naturally found on the body may be the main cause of chronic sinusitis. Like bacterial sinusitis, fungal sinusitis is caused when it becomes trapped in the sinuses and multiplies there. Patients with depressed immune systems such as those with HIV or those taking medication to suppress their immune system such as organ transplant patients are particularly susceptible to fungal sinusitis on a longterm basis. Myasthenia gravis and amyotrophic lateral sclerosis (ALS) are both autoimmune diseases that causes muscle atrophy and paralysis and may also limit your ability to clear and drain mucous, increasing your probability of contracting respiratory illnesses that cause chronic sinusitis .
Recurring acute sinusitis can lead to chronic sinusitis. Cystic fibrosis and chronic bronchitis are conditions that cause your body to produce excessive amounts of mucous. Cystic fibrosis also increases the viscosity of the mucous by making it thicker, sticky, and more difficult to cough up. The result of these conditions is repeated coughing, irritation, and pooling of mucous which can all result in chronic sinusitis. Your doctor may consider a chest X-ray, blood tests, a sweat test, or sinus culture tests to determine or rule out the existence of underlying health conditions.
Although acute sinusitis is more likely to cause more intense symptoms such as severe facial pain, chronic sinusitis is more stubborn and may not respond to home remedies or even prescribed medication. Patients with chronic sinusitis that does not respond to treatment may be candidates for surgery.