What is sinusitis? Learn about its symptoms, causes, types and treatments.

Persistent nasal congestion, accompanied by headaches and pain or pressure in the cheeks? This may be more than just a common cold—it could be sinusitis. Sinusitis is a common but often overlooked condition. If left untreated, it may become chronic and recur frequently, and in severe cases, it can significantly affect quality of life. This article provides a detailed overview of the causes, symptoms, diagnostic methods and treatments for sinusitis, helping you to prevent and manage the condition more effectively.

The sinuses are hollow structures in the skull that connect to the nasal cavity and are lined with a mucus-secreting membrane. Mucus helps keep the nasal cavity moist and filters dust and bacteria from the air.

When the lining of the nasal passages and sinuses becomes infected or irritated, triggering an inflammatory response, sinusitis develops. It can affect people of any age and is divided into acute sinusitis and chronic sinusitis:

Acute sinusitis

Acute sinusitis is usually caused by a viral or bacterial infection. Symptoms last for less than 4 weeks, develop rapidly and often occur alongside a cold. Mild cases may resolve on their own, while severe cases may require treatment with antibiotics.

Chronic sinusitis

If the inflammation persists for more than 12 weeks, it is classified as chronic sinusitis. It is common in people who experience recurrent episodes or have a weakened immune system. Symptoms tend to be more persistent, such as nasal congestion, facial tenderness and a reduced sense of smell. Long-term treatment is usually required, and surgery may sometimes be necessary.

The symptoms of sinusitis are often similar to those of a cold or nasal allergies, but they last longer and are also more severe. Common symptoms include:

• Facial pain or pressure, particularly around the brow bones, cheeks and eyes
• Persistent nasal congestion
• Thick yellow or green nasal discharge
• A cough caused by post-nasal drip, which is worse at night
• Bad breath and an unpleasant smell in the nose
• Reduced sense of smell and taste
• Fever and fatigue
• Headache, nausea and dizziness (vertigo) in more severe cases

Sinusitis usually stems from the following factors:

• External irritants such as pollen, dust, mould, cold air, alcohol and perfume
• Abnormal nasal structure (such as a deviated septum or nasal polyps)
• Chronic allergies or asthma
• Dental infections spreading to the sinuses
• Weakened immunity (such as in people with AIDS or cancer)
• Smoking

When swollen mucous membranes block the nasal passages, mucus cannot drain from the sinuses, allowing bacteria or fungi to multiply extensively and cause an infection.

Doctors will usually first carry out an initial assessment, including:

• Taking a medical history and performing a facial palpation examination: to understand when the symptoms started and their severity, and to check whether there is tenderness or swelling around the forehead, eyes or cheeks.
• Transillumination examination: shining a strong light on the forehead or cheeks in a dark room to determine whether the sinuses are blocked.

If necessary, the doctor will arrange further examinations, including:

• X-ray: to quickly determine whether there is fluid in the sinuses, although its accuracy is limited.
• Computerised tomography (CT Scan): provides clear images to assess whether there is any blockage or structural abnormality, and is commonly used for chronic sinusitis.
• Magnetic resonance imaging (MRI): used to examine the soft tissues around the sinuses and assess whether the inflammation has spread.
• Nasal endoscopy: inserting a small camera into the nasal cavity to directly observe the internal structures of the sinuses, suitable for assessing chronic or complex cases.

Most cases of acute sinusitis are mild infections that can usually be managed at home and resolve within a few days. Common self-care methods include:

• Get plenty of rest and drink plenty of water: This helps the body recover and promotes the drainage of nasal secretions.
• Inhale hot steam: This relieves nasal congestion and helps keep the sinuses clear.
• Take fever and pain-relieving medication (such as ibuprofen or paracetamol): This relieves symptoms such as headache, fever and facial tenderness.
• Use nasal decongestants (such as nasal sprays or menthol inhalants): These relieve nasal congestion, but should not be used for more than one week, otherwise they may worsen nasal congestion.

If symptoms persist for more than one week without improvement, seek medical attention promptly. Your doctor may recommend the following treatments depending on your condition:

• Antibiotic treatment (3 to 10 days): For sinusitis caused by a bacterial infection, helping to reduce inflammation and eliminate bacteria.
• Steroid nasal sprays or antihistamines: Suitable for patients with chronic sinusitis or accompanying allergies, relieving mucosal swelling and inflammation.
• Nasal irrigation (with saline solution): Cleans the nasal passages, reduces the build-up of secretions and helps prevent sinusitis flare-ups.

For patients with chronic or severe sinusitis, surgery may be required if medication is not sufficiently effective:

• Functional endoscopic sinus surgery (FESS): Uses an endoscope to remove obstructive or infected tissue and restore sinus drainage.
• Balloon sinuplasty: A minimally invasive procedure that uses a balloon to widen the sinus openings, helping mucus drain. It causes less surgical trauma and offers a faster recovery.

These treatments can effectively relieve sinusitis symptoms and prevent recurrent flare-ups. The choice of treatment should be based on your doctor’s advice and your individual condition.

Although most cases of acute sinusitis are mild infections that can be managed at home, you should seek medical attention as soon as possible if you experience any of the following:

• A high fever that persists
• Severe facial swelling or confusion
• Blurred vision, a stiff neck or seizures
• Symptoms that persist for more than a week without improvement
• Recurrent sinusitis

Take the following measures in daily life to reduce the risk of sinusitis:

• Keep the air humid and use an air purifier
• Clean dust in the home regularly and remove dust and mould
• Avoid exposure to allergens (such as pet hair and pollen)
• Do not smoke and reduce alcohol consumption
• Use a nasal decongestant spray before entering a swimming pool to prevent irritation
• Undergo allergy treatment (such as desensitisation injections)

Although sinusitis is not a serious illness, recurrent episodes may require surgery. In Hong Kong, sinus surgery at private hospitals can be expensive. At CUHK Medical Centre, for example, the day-case medical fee for functional endoscopic sinus surgery is as high as HK$99,200, and it can be even more expensive if hospitalisation is required.

Having suitable medical insurance can effectively reduce the financial burden. The Voluntary Health Insurance Scheme (VHIS) not only provides reimbursement-based hospitalisation coverage, but also offers tax deductions, providing dual protection for your health and finances.

If you would like to find out which Voluntary Health Insurance Scheme plan best suits your needs, feel free to consult a 10Life licensed insurance adviser for impartial and professional advice.

Further reading:

References:

1. Mayo Clinic. Chronic sinusitis
2. Mayo Clinic. Acutesinusitis
3. Cleveland Clinic. Sinus Infection (Sinusitis)

This article was last updated on 2 October 2025

This English version of this article has been generated by machine translation powered by AI. It is provided solely for reference purposes. In the event of any discrepancy or inconsistency between this translation and the original Chinese version, the Chinese version shall prevail.