Chronic sinusitis and nasal polyps
Inflammation of the nose and sinuses lasting twelve weeks or longer. It affects roughly 5 to 10 in every 100 adults.
Chronic rhinosinusitis behaves like a long-term inflammatory condition, closer to asthma or eczema than to a lingering infection. That is why repeated courses of antibiotics so often fail to fix it.
Some people have it with nasal polyps, which are soft, non-cancerous swellings of the inflamed lining. Others have it without. The difference matters, because it guides treatment.
What it feels like
- Pressure or pain around the eyes, cheeks, nose or forehead
- A blocked nose, or trouble breathing through it
- Discoloured discharge, or mucus down the back of the throat
- Reduced or absent sense of smell, especially with polyps
- Fullness or discomfort in the ears
Poor sleep, tiredness and trouble concentrating usually follow, and often affect daily life more than the nasal symptoms do.
How it is diagnosed
Examination of the nose with a fine endoscope, uncomfortable for a few seconds but not painful, and usually a CT scan. The scan shows the parts of the sinuses that cannot be seen from inside the nose, and maps the anatomy if surgery is being considered.
How it is treated
Treatment aims at long-term control rather than a single course of medication. Daily salt water rinses and steroid sprays or rinses do most of the work, and they only work when they are actually done daily. Allergy, asthma and smoking are treated alongside, because each makes sinus disease worse.
If symptoms persist despite well-taken medical treatment, endoscopic sinus surgery opens the natural drainage pathways and removes polyps. It is done through the nostrils, with no cuts on the face. Surgery is not a cure on its own. It relieves the obstruction so that rinses and sprays reach the sinus lining, and medical treatment continues afterwards.
For severe polyp disease that surgery and full medical treatment do not control, injectable biologic medicines can shrink polyps and restore smell. Ask whether you might be eligible.
See a doctor promptly if you have
- Swelling or redness around an eye, double vision, or reduced vision
- Severe one-sided headache, high fever, drowsiness or confusion
- Symptoms strictly on one side. One-sided blockage, bleeding or numbness should always be examined
- Clear, watery fluid dripping from one nostril, worse on leaning forward
Patients under my care receive a detailed handout covering the rinse method, spray technique and the medications in their plan.
This page is general information and does not replace advice about your own case. Reviewed August 2026.