Acute sinusitis is usually short-lived and generally occurs after a common cold. A green or yellow nasal discharge occurs a week or more after the onset of the cold and this can be associated with severe pain around the cheeks, eyes and/or forehead. The nose is blocked, and there may be a fever and pain in the upper teeth.
Chronic sinusitis is sinusitis that continues for several months. Chronic sinusitis may be caused by an acute sinus infection, which fails to settle down. Common symptoms include nasal obstruction, nasal discharge and a reduced sense of smell. Facial pain or headache is less apparent and often absent in this type of sinusitis.
The diagnosis of sinusitis involves the use of a nasal endoscope, which is used to examine the sinus openings. This is not a painful procedure and takes only about 30 seconds to perform.
Acute sinusitis is treated with antibiotics and decongestants. Chronic sinusitis may need long courses of antibiotics together with steroid drops to reduce inflammation. Saline irrigations are also useful. In the vast majority of cases sinusitis can be managed effectively with medical treatment alone but sometimes symptoms will persist and surgery may be advised.
Sinus operations are performed under a general anaesthetic to put you to sleep and most patients go home the same day. There are usually no external incisions and operations are performed with specially designed instruments that are small enough to fit into your nostrils. Consultants will ask for a scan of the sinuses to assist with the planning of the operation. Sometimes consultants use a special machine called Image Guidance to navigate their way through the sinuses. This is useful in complex cases and revision surgery and makes the operation safer.