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Am Fam Physician. 2017;96(8):online

See related article on chronic rhinosinusitis

What is chronic rhinosinusitis?

Chronic rhinosinusitis happens when the lining of the sinuses swells because of inflammation. It is also called chronic sinusitis. Sometimes, the swelling is so severe that you get polyps (noncancerous growths) in your nose and sinuses. The sinuses are air-filled spaces in your forehead, in your cheeks, between your eyes, and even deep within your head. They drain into your nose.

What causes it?

The cause of chronic rhinosinusitis is mostly unknown, but it is not caused by an infection. Instead, it is thought to be caused by your immune system overreacting to something in the sinuses.

Very rarely, it may be caused by another condition such as a poor immune system, swelling of blood vessels, cystic fibrosis, or primary ciliary dyskinesia.

How do I know if I have it?

Your doctor will ask you about your symptoms. He or she can also find clues by looking inside your nose and by taking pictures of the inside of your face using a computed tomography (CT) scan.

Symptoms include nasal blockage, nasal drainage, pain or pressure in your face, and decreased sense of smell. These symptoms last at least three months. You may need to see an ear, nose, and throat (ENT) doctor. The ENT doctor can look inside your nose with a small camera. This is called endoscopy. It is quick and painless, and done in the doctor's office while you are awake.

How is it treated?

Chronic rhinosinusitis can be treated by washing out your nose daily with saline (salt water) and by using nasal steroid sprays. Saline washes and steroid sprays are available over-the-counter, but talk to your doctor about how to use them the right way. Your doctor can also tell you how long to use these treatments.

If you are still having symptoms, your doctor may have you also take steroid pills for a short time. Sometimes, sinus surgery is needed.

What should I expect?

Although the main effects of chronic rhinosinusitis are sinus and nasal symptoms, you can also have ear problems (like, ear pressure and pain), dizziness, poor sleep, and depressed mood. These symptoms may reduce your quality of life. Treating your symptoms may lower the impact chronic rhinosinusitis has on you and your life. There is no cure for chronic rhinosinusitis, so you may need long-term treatment.

Where can I get more information?

Your doctor

American Academy of Otolaryngology–Head and Neck Surgery

American Rhinologic Society

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