🌿 Chronic Sinusitis (CRS)

🧾 What it is

• Long-lasting inflammation of the paranasal sinuses, persisting >12 weeks.
• May occur with nasal polyps (CRSwNP) or without polyps (CRSsNP).
• Often associated with asthma, allergies, or structural nasal problems.

🔍 Symptoms

Main features (at least 2 of the 4 key ones are required for diagnosis):

1. Nasal congestion / obstruction
2. Facial pain or pressure (around eyes, forehead, cheeks)
3. Thick nasal discharge (anterior or post-nasal drip)
4. Reduced or lost sense of smell (anosmia)

Other possible symptoms:

• Chronic cough (esp. at night due to drip)
• Halitosis (bad breath)
• Fatigue, malaise
• Ear pressure or fullness
• Dental pain (upper teeth)

🧪 Diagnosis

1. History & Symptoms – duration >12 weeks + typical complaints.
2. Physical exam – nasal endoscopy: mucosal swelling, pus, polyps.
3. Imaging (CT scan of sinuses) – gold standard for structural changes (sinus opacification, blockage).
4. Lab tests (if needed):
   • Allergy testing
   • Immune function tests (if recurrent/severe)

💊 Treatment

Allopathic / Conventional

First-line:

• Saline irrigation (isotonic or hypertonic) – clears mucus and allergens.
• Intranasal corticosteroid sprays (fluticasone, mometasone, budesonide) – reduce swelling/inflammation.

Additional options:

• Short-course oral corticosteroids – for severe cases or nasal polyps which include Prednisone, Methylprednisolone etc.
• Antibiotics – only if bacterial infection suspected (not for routine CRS). Amoxicillin-clavulanate (Augmentin), Doxycycline, Levofloxacin (reserved for resistant cases).
• Antihistamines – if allergies involved. Cetirizine (Zyrtec), Loratadine (Claritin), Fexofenadine (Allegra)
• Leukotriene modifiers (montelukast) – in allergic or aspirin-sensitive patients.
• Biologics (new, advanced): Dupilumab (Dupixent) – anti-IL4Rα antibody, reduces polyps and inflammation. Omalizumab – for allergic CRS in selected cases

Surgical:

• Functional Endoscopic Sinus Surgery (FESS) – for patients unresponsive to maximal medical therapy; restores sinus drainage.

Home / Natural Remedies

(Supportive, not a replacement for medical care)

• 🌊 Steam inhalation or hot showers → loosen mucus, relieve congestion.
• 💧 Homemade saline rinse (distilled/boiled water + salt + baking soda) in a neti pot or squeeze bottle.
• 🌿 Warm compresses over sinuses → reduce pressure.
• 🛌 Elevate head during sleep → reduce nighttime congestion.
• 🍯 Ginger, turmeric, honey teas → natural anti-inflammatory support (mild benefit).
• 🌬 Humidifier in dry environments → prevent mucosal irritation.

⚠️ Always use sterile/distilled/boiled water for nasal rinses to avoid rare infections.

🛡 Prevention

• Manage allergies/asthma → reduces CRS risk.
• Avoid smoking/second-hand smoke → major irritant.
• Reduce exposure to pollutants, dust, strong odors.
• Maintain good nasal hygiene → regular saline rinses in prone individuals.
• Stay hydrated → thins mucus.
• Prompt treatment of acute sinus infections → prevents progression to chronic.

🚨 When to Seek Medical Help

• Severe headache, vision changes, eye swelling
• High fever
• Confusion, stiff neck
  (these can signal dangerous complications spreading to eye or brain).

✅ In summary:
Chronic sinusitis is a long-lasting sinus inflammation with congestion, discharge, pain/pressure, and smell loss. Diagnosis relies on symptoms + imaging, treatment ranges from nasal sprays and rinses to surgery, while home remedies can ease symptoms. Prevention = allergy control + nasal hygiene + avoiding irritants.