What is sinusitis? Learn about the symptoms, causes, types, and treatment methods of sinusitis.

Persistent nasal congestion, or even headaches and facial pain? This may not just be a common cold, but sinusitis at play. Sinusitis is a common yet often overlooked condition. If not treated promptly, it may become chronic and recur repeatedly, and in severe cases, it could significantly affect quality of life. This article will provide a detailed explanation of the causes, symptoms, diagnostic methods, and treatment options for sinusitis, helping everyone to better prevent and manage the condition.

The sinuses are hollow cavities within the skull, connected to the nasal cavity and lined with a mucous membrane that secretes mucus. The role of mucus is to keep the nasal cavity moist and to filter dust and bacteria from the air.

When the mucous membrane in the nasal passages and sinuses becomes infected or irritated, triggering an inflammatory response, sinusitis develops. People of any age can be affected, and sinusitis is classified into acute sinusitis and chronic sinusitis:

Acute Sinusitis

Acute sinusitis is typically caused by a viral or bacterial infection, with symptoms lasting less than 4 weeks. It often develops quickly and is commonly associated with a cold. Mild cases may resolve on their own, while severe cases might require antibiotic treatment.

Chronic Sinusitis

If the inflammation persists for more than 12 weeks, it is classified as chronic sinusitis. This condition is common in individuals with recurrent episodes or weakened immunity. Symptoms are often persistent, including nasal congestion, facial tenderness, and reduced sense of smell. It usually requires long-term treatment and, in some cases, surgical intervention.

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

• Facial pain or pressure, especially in the areas of the eyebrows, cheeks, and around the eyes
• Persistent nasal congestion
• Thick yellow or green nasal discharge
• Postnasal drip causing cough, worsening at night
• Bad breath or unpleasant odour in the nasal cavity
• Reduced sense of smell and taste
• Fever and fatigue
• Headache, nausea, dizziness (vertigo) (in more severe cases)

Sinusitis typically arises from the following factors:

• External irritants such as pollen, dust, mould, cold air, alcohol, and perfume
• Structural abnormalities in the nasal cavity (e.g., deviated nasal septum, nasal polyps)
• Chronic allergies or asthma
• Dental infections spreading to the sinuses
• Weakened immunity (e.g., in individuals with AIDS or cancer)
• Smoking

When the mucous membrane swells and blocks the nasal cavity, mucus in the sinuses cannot drain, allowing bacteria or fungi to multiply extensively and cause infection.

Doctors usually conduct an initial assessment, which includes:

• Medical history inquiry and facial palpation examination: Understanding the onset and severity of symptoms, and checking for tenderness or swelling in the forehead, around the eyes, or cheeks.
• Transillumination test: Using a strong light to illuminate the forehead or cheeks in a dark room to determine if the sinuses are blocked.

If necessary, doctors may arrange further tests, including:

• X-ray: A quick method to check for fluid accumulation in the sinuses, though its accuracy is limited.
• Computed Tomography (CT Scan): Provides clear images to assess for blockages or structural abnormalities, commonly used for chronic sinusitis.
• Magnetic Resonance Imaging (MRI): Used to examine soft tissues near the sinuses and evaluate whether inflammation has spread.
• Nasal endoscopy: Involves inserting a small camera into the nasal cavity to directly observe the internal structure of the sinuses, suitable for assessing chronic or complex cases.

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

• Get plenty of rest and stay hydrated: This helps the body recover and promotes the drainage of nasal secretions.
• Inhale warm steam: This can relieve nasal congestion and help clear the sinuses.
• Take fever-reducing painkillers (such as ibuprofen or paracetamol): These can alleviate symptoms like headaches, fever, and facial tenderness.
• Use nasal decongestants (such as nasal sprays or menthol inhalants): These can ease nasal congestion, but should not be used for more than a week, as prolonged use may worsen congestion.

If symptoms persist for more than a week without improvement, it is advisable to seek medical attention promptly. A doctor may recommend the following treatments based on the condition:

• Antibiotic treatment (3 to 10 days): For sinusitis caused by bacterial infections, this helps reduce inflammation and eliminate bacteria.
• Steroid nasal sprays or antihistamines: Suitable for patients with chronic sinusitis or associated allergies, these help reduce mucosal swelling and inflammation.
• Nasal irrigation (saline solution): This cleanses the nasal passages, reduces mucus buildup, and helps prevent sinusitis flare-ups.

For patients with chronic or severe sinusitis, if medication proves ineffective, surgical intervention may be necessary:

• Functional Endoscopic Sinus Surgery (FESS): This procedure uses an endoscope to remove blockages or infected tissue, restoring sinus drainage.
• Balloon Sinuplasty: A minimally invasive surgery that uses a balloon to dilate sinus openings, facilitating mucus drainage with minimal trauma and faster recovery.

These treatment options can effectively relieve sinusitis symptoms and prevent recurrent episodes. The choice of treatment should be determined based on medical advice and the individual’s specific condition.

Although most cases of acute sinusitis are mild infections that can be managed with self-care at home, you should seek medical attention promptly if you experience the following:

• Persistent high fever
• Severe facial swelling or confusion
• Blurred vision, neck stiffness, or seizure symptoms
• Symptoms persisting for more than a week without improvement
• Recurrent sinusitis

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

• Maintain air humidity by using an air purifier
• Regularly clean dust at home, and remove dust and mould
• Avoid contact with allergens (such as pet hair and pollen)
• Do not smoke and reduce alcohol consumption
• Use a nasal spray before entering swimming pools to prevent irritation
• Undergo anti-allergy treatments (such as desensitisation injections)

Although sinusitis is not a severe illness, repeated episodes may necessitate surgical treatment. In Hong Kong, the cost of sinus surgery at private hospitals is relatively high. For instance, at the Chinese University of Hong Kong Medical Centre, the day-care medical expense for functional endoscopic sinus surgery can be as high as HKD 99,200, and the cost could be even higher if hospitalisation is required.

Having suitable medical insurance can effectively alleviate the financial burden. The Voluntary Health Insurance Scheme (VHIS) not only provides reimbursement for hospitalisation expenses but also offers tax deduction benefits, ensuring both health and financial protection.

If you wish to find out which Voluntary Health Insurance Scheme best suits your needs, feel free to consult 10Life licensed insurance advisors 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.