Solutions for Stubborn Sinus Infections


If you’ve ever had a sinus infection, you know how miserable it can make you feel. Your nose is stuffy and congested, there’s pressure and pain in your face and then there’s that mucus. This often happens when you have a cold. The good news is that most sinus infections go away in about two weeks with the help of decongestants, nasal sprays and other remedies.

But if you have sinus problems for three months or longer, you may have chronic sinusitis, also called chronic rhinosinusitis.

“Chronic rhinosinusitis affects more than 11 million people in the United States, and it can significantly impact someone’s life,” says Christopher F. Thompson, MD, a board-certified otolaryngologist (ear, nose and throat specialist) at Mission Hospital.

Dr. Thompson explains that the sinuses are essentially air pockets in the bones of the face and head. They are lined with a thin layer of tissue that generates a small amount of mucus to keep the sinuses lubricated and flush away germs.

“Rhinosinusitis occurs when the sinus lining becomes infected or swollen, creating extra mucus,” says Dr. Thompson, who is fellowship-trained in complex sinus and endoscopic surgery. “The swollen lining may also inhibit the drainage of mucus, which serves as a reservoir for bacteria.”

Symptoms of chronic rhinosinusitis include:

  • Nasal congestion or obstruction
  • Mucus drainage or discharge
  • Facial pressure or pain
  • Reduced sense of smell

People with chronic rhinosinusitis may also have headaches, fatigue, postnasal drip and difficulty sleeping, Dr. Thompson says.

Several things can make you more vulnerable to chronic rhinosinusitis, including a genetic predisposition to recurrent sinus infections and nasal polyps, and allergies to dust mites, dander and molds.

A doctor diagnoses chronic rhinosinusitis using a CT scan or nasal endoscopy—a routine office procedure where a small, illuminated video camera is inserted in the nose.

Treatment Options

Fortunately, there’s a lot doctors can do to help you with your symptoms. Your doctor may suggest:

  • Nasal irrigation with a saline solution. This can work well in removing irritants and sources of inflammation from the nasal passages. Your doctor may recommend a syringe or a neti pot.
  • A nasal decongestant spray.
  • Oral steroids to reduce sinus inflammation, shrink nasal polyps, improve congestion and relieve facial pressure. But, there’s a downside: “Long-term use of oral steroids can have serious side effects—so we’re always very careful when prescribing oral steroids,” Dr. Thompson says.
  • Antibiotics, which can help reduce bacterial sinus infections—and there are a lot of options.

If your symptoms don’t get better with medications and other treatments, your doctor may recommend surgery.