About two thirds of people who get sinusitis do not need to see their GP. Most cases are caused by a viral infection, which often clears up by itself.
Sinusitis takes about two-and-a-half weeks to clear, so it lasts longer than the common cold.
If you have mild sinusitis you can take over-the-counter painkillers and decongestants to relieve your symptoms (see box, right).
Seeking treatment from your GP
See your GP if your symptoms do not improve after seven days, if they are getting worse, or if the sinusitis keeps coming back.
In these cases, treatment options are:
- antibiotics
- steroid sprays or drops
- surgery (if other treatments have failed).
However, these treatments are only used for severe cases of sinusitis.
Your GP may refer you to an ear, nose and throat (ENT) specialist, who will carry out some tests to determine the underlying cause of your chronic (persistent) sinusitis. Chronic sinusitis may last for several months.
Antibiotics
If your symptoms are severe and your sinusitis has not cleared within seven days, your GP may prescribe you antibiotics. About one third of people with sinusitis will develop a bacterial infection that requires antibiotics.
Steroid sprays or drops
Steroid sprays, drops or implants are usually prescribed if you are diagnosed with chronic sinusitis, as they can help to reduce your swollen sinuses.
Surgery
If your symptoms do not improve after a course of antibiotics, and you are still experiencing difficulties with your affected sinuses, functional endoscopic sinus surgery (FESS) may be recommended. This is the most common operation for sinusitis and can be successful in relieving the symptoms.
FESS is usually done under general anaesthetic (you are put to sleep), but it can also be done under local anaesthetic (where your nose is numbed).
The surgeon will insert an endoscope into your nose. This is a thin tube with a lens that magnifies the inside of your nose. They will then be able to see the opening of your sinus drainage channels.
The surgeon will either:
- remove any tissues, such as nasal polyps (growths), which are blocking the affected sinus
- inflate a tiny balloon inside your nose, to open up the drainage passages from your sinuses (this is called a balloon catheter dilation)
The operation will improve your sinus drainage and will help the sinus to function properly.
The surgeon may also insert a self-dissolving implant into your sinuses, which expands to prop the sinuses open and deliver the steroid drug mometasone directly to the sinus lining.
For more information, read ENT UK's leaflet on functional endoscopic sinus surgery and the 2008 guidelines from the National Institute for Health and Clinical Excellence (NICE) on balloon catheter dilation for chronic sinusitis.
