Przewlekłe zapalenie zatok
Objawy

Przewlekłe zapalenie zatok przynosowych (sinusitis chronica) definiuje się jako utrzymujący się ponad 12 tygodni stan zapalny zatok, charakteryzujący się co najmniej dwoma z następujących objawów: utrudnione oddychanie przez nos (81-95% pacjentów), wydzielina z nosa lub spływanie po tylnej ścianie gardła, ból lub uczucie pełności w obrębie twarzy oraz osłabienie lub utrata węchu (hiposmia/anosmia). W odróżnieniu od ostrego zapalenia zatok, przewlekły przebieg cechuje się łagodniejszymi, lecz długotrwałymi symptomami, bez typowej gorączki. Dodatkowo mogą występować objawy takie jak gęsta, żółta lub zielona wydzielina, ból zatok o różnej lokalizacji, przewlekły kaszel nasilający się nocą, zmęczenie, halitoza oraz zaburzenia snu i koncentracji, co znacząco obniża jakość życia pacjentów. Przewlekłe zapalenie zatok może mieć postać z polipami nosa lub bez, a także alergiczne grzybicze zapalenie zatok, z możliwym zaostrzeniem objawów i powikłaniami oczodołowymi, neurologicznymi oraz ogólnoustrojowymi, takimi jak zapalenie opon mózgowo-rdzeniowych czy zakrzepica zatoki jamistej.

Objawy przewlekłego zapalenia zatok

Przewlekłe zapalenie zatok przynosowych (sinusitis chronica) to stan zapalny przestrzeni powietrznych wewnątrz nosa i głowy, który utrzymuje się przez 12 tygodni lub dłużej, nawet pomimo stosowanego leczenia. W przeciwieństwie do ostrego zapalenia zatok, które zazwyczaj ustępuje w ciągu 10 dni, przewlekłe zapalenie zatok charakteryzuje się długotrwałym utrzymywaniem się objawów i może znacząco wpływać na jakość życia pacjenta12.

Główne objawy przewlekłego zapalenia zatok

Do rozpoznania przewlekłego zapalenia zatok wymagane jest występowanie co najmniej dwóch z czterech głównych objawów trwających ponad 12 tygodni3:

56

Objawy przewlekłego zapalenia zatok mogą być podobne do objawów ostrego zapalenia, jednak są zazwyczaj łagodniejsze i utrzymują się znacznie dłużej7. W przeciwieństwie do ostrego zapalenia zatok, gorączka nie jest typowym objawem przewlekłego zapalenia zatok8.

Szczegółowe objawy przewlekłego zapalenia zatok

Oprócz głównych objawów, pacjenci z przewlekłym zapaleniem zatok mogą doświadczać wielu dodatkowych dolegliwości910:

  • Wydzielina z nosa – gęsta, żółta lub zielona wydzielina nosowa, czasem z domieszką krwi11
  • Spływanie wydzieliny po tylnej ścianie gardła (post-nasal drip) – powodujące podrażnienie gardła i odruch kaszlowy, szczególnie nasilający się w nocy12
  • Ucisk i ból zatok – może obejmować różne obszary twarzy:
    • Ból czoła i okolic oczu
    • Ból kości policzkowych i górnej szczęki
    • Ból promieniujący do tylnej części głowy
  • Ból zębów – szczególnie górnej szczęki
  • Ból uszu lub uczucie ciśnienia w uszach
  • Ból głowy – zazwyczaj zlokalizowany w przedniej części głowy
  • Przewlekły kaszel – często nasilający się w nocy
  • Zmęczenie i osłabienie
  • Nieprzyjemny zapach z ust (halitosis)
  • Ból gardła lub chrypka spowodowane spływaniem wydzieliny

1314

Dolegliwości te mogą znacząco wpływać na codzienne funkcjonowanie, powodując trudności w oddychaniu, koncentracji, zaburzenia snu i ogólne pogorszenie jakości życia15.

Przebieg przewlekłego zapalenia zatok

Przewlekłe zapalenie zatok rozwija się stopniowo w ciągu miesięcy lub lat, choć może też rozpocząć się nagle jako zakażenie górnych dróg oddechowych lub ostre zapalenie zatok, które nie zostało wyleczone16. Przed rozwinięciem się przewlekłego zapalenia zatok pacjent może doświadczyć wielu epizodów ostrego zapalenia17.

Różnice między ostrym a przewlekłym zapaleniem zatok

Rozróżnienie między ostrym a przewlekłym zapaleniem zatok opiera się głównie na czasie trwania objawów18:

  • Ostre zapalenie zatok – objawy trwają krócej niż 4 tygodnie, często towarzyszą przeziębieniu lub infekcji dróg oddechowych
  • Przewlekłe zapalenie zatok – objawy utrzymują się przez 12 tygodni lub dłużej, mimo prób leczenia

Podczas gdy objawy ostrego zapalenia zatok są zwykle bardziej intensywne i nasilone, przewlekłe zapalenie zatok charakteryzuje się łagodniejszymi, ale długotrwałymi dolegliwościami19. W przeciwieństwie do ostrego zapalenia, przewlekłe zapalenie zatok rzadko powoduje wysoką gorączkę20.

Typy przewlekłego zapalenia zatok

Przewlekłe zapalenie zatok może występować w kilku postaciach klinicznych2122:

  • Przewlekłe zapalenie zatok bez polipów nosa
  • Przewlekłe zapalenie zatok z polipami nosa – polipy nosowe stanowią poważny obrzęk błony śluzowej zatok, mogą powodować utratę węchu i ból twarzy23
  • Alergiczne grzybicze zapalenie zatok

Obecność polipów nosowych lub problemów strukturalnych w przewodach nosowych może prowadzić do przewlekłego zapalenia zatok i wpływać na przebieg choroby24.

Wzorce przebiegu objawów

Objawy przewlekłego zapalenia zatok mogą przebiegać w różny sposób25:

  • Mogą się nasilać i słabnąć w czasie (fluktuować)
  • Mogą poprawiać się lub pogarszać w różnych okresach
  • Mogą utrzymywać się miesiącami lub nawet latami

Niektóre badania wskazują, że objawy mogą utrzymywać się nawet przez ponad dekadę26. Przewlekłe zapalenie zatok może również powodować ostre zaostrzenia, podobnie jak w przypadku astmy27.

Wpływ na jakość życia

Przewlekłe zapalenie zatok może znacząco wpływać na jakość życia pacjentów28. Długotrwałe objawy mogą powodować:

  • Zmęczenie i wyczerpanie – objawy te mogą być najbardziej uciążliwe dla niektórych pacjentów29
  • Zaburzenia snu – spowodowane niedrożnością nosa i trudnościami w oddychaniu30
  • Obniżenie nastroju lub depresję – długotrwałe objawy mogą prowadzić do zmęczenia i depresji31
  • Problemy z koncentracją – pacjenci mogą odczuwać trudności z koncentracją i myśleniem32

U osób cierpiących zarówno na depresję, jak i przewlekłe zapalenie zatok, te dwa stany mogą wzajemnie się nasilać, pogarszając objawy33.

Powikłania przewlekłego zapalenia zatok

Nieleczone przewlekłe zapalenie zatok może prowadzić do poważnych powikłań, które mogą zwiększać chorobowość i śmiertelność3435.

Miejscowe powikłania

Zakażenie może rozprzestrzeniać się z zatok na okoliczne struktury36:

  • Powikłania oczodołowezapalenie tkanki oczodołu (cellulitis orbitalis), które może prowadzić do zaburzeń widzenia i deficytów neurologicznych37
  • Śluzowiaki zatok przynosowych – mogą powstawać w wyniku nieleczonego zapalenia zatok38
  • Problemy z zębami – ból i nadwrażliwość zębów z powodu bliskości zatok szczękowych39

Powikłania ogólnoustrojowe

W rzadkich przypadkach, przewlekłe zapalenie zatok może prowadzić do poważnych powikłań ogólnoustrojowych4041:

  • Zapalenie opon mózgowo-rdzeniowych – zakażenie rozprzestrzeniające się na błony i płyn otaczający rdzeń kręgowy i mózg
  • Ropień mózgu – gromadzenie się ropy w mózgu
  • Zakrzepica zatoki jamistej – tworzenie się zakrzepu krwi w podstawie mózgu

Te poważne powikłania są rzadkie, ale potencjalnie zagrażające życiu42.

Wpływ na układ oddechowy

Przewlekłe zapalenie zatok może zaostrzać istniejące schorzenia układu oddechowego43:

  • Zaostrzenie astmy – przewlekłe zapalenie zatok jest związane z zaostrzeniem astmy
  • Zapalenie oskrzeli i zapalenie płuc – mogą wystąpić jako powikłania44
  • Chrapanie i obturacyjny bezdech senny – mogą być nasilone przez niedrożność nosa45

Badania wykazały, że im cięższe staje się przewlekłe zapalenie zatok, tym większe prawdopodobieństwo wystąpienia poważnych problemów płucnych46.

Postępowanie i rokowanie

Leczenie przewlekłego zapalenia zatok koncentruje się na kontrolowaniu lub łagodzeniu stanu zapalnego47. W przeciwieństwie do ostrego zapalenia zatok, które często jest wywoływane przez infekcję wirusową i ustępuje samoistnie, przewlekłe zapalenie zatok wymaga zwykle długoterminowego leczenia48.

Leczenie farmakologiczne

Leczenie przewlekłego zapalenia zatok obejmuje49:

  • Donosowe spraye steroidowe – zmniejszają stan zapalny
  • Topiczne lub doustne leki przeciwhistaminowe – szczególnie w przypadku alergicznego podłoża
  • Antagoniści leukotrienów (np. montelukast)
  • Antybiotyki – w przypadku infekcji bakteryjnej, zwykle przez dłuższy okres (4-6 tygodni)50

Przewlekłe zapalenie zatok najczęściej nie jest spowodowane infekcją bakteryjną, dlatego leczenie antybiotykami nie zawsze jest skuteczne51.

Leczenie chirurgiczne

Jeśli leczenie zachowawcze nie przynosi efektów, może być konieczne leczenie chirurgiczne52:

  • Funkcjonalna endoskopowa chirurgia zatok (FESS) – otwiera zablokowane zatoki, umożliwiając lepsze odprowadzanie wydzieliny53
  • Usunięcie polipów nosowych (polipektomia) – pozwala na lepsze odprowadzanie wydzieliny z zatok54
  • Korekcja przegrody nosowej – w przypadku skrzywienia przegrody nosowej55

Chirurgia zatok jest skuteczna w leczeniu przewlekłego zapalenia zatok u około 75-90% pacjentów, którzy nie reagują na leczenie farmakologiczne5657.

Rokowanie

Rokowanie w przewlekłym zapaleniu zatok zależy od jego przyczyny58:

  • Często konieczne jest stosowanie leków lub zabiegów chirurgicznych w celu zmniejszenia stanu zapalnego lub skorygowania niedrożności
  • W wielu przypadkach stan zapalny musi być kontrolowany lekami przez długi czas, aby zapobiec nawrotom
  • Przewlekłe zapalenie zatok może wymagać długoterminowego leczenia, aby utrzymać objawy pod kontrolą59

Dzięki odpowiedniemu leczeniu, większość pacjentów z przewlekłym zapaleniem zatok doświadcza znacznej poprawy objawów60. Jednak całkowite wyleczenie może nie być możliwe we wszystkich przypadkach, a celem leczenia jest raczej kontrola objawów i poprawa jakości życia61.

Kiedy szukać pomocy medycznej

Należy skonsultować się z lekarzem w następujących przypadkach6263:

  • Objawy zapalenia zatok utrzymują się dłużej niż 10-12 dni
  • Objawy poprawiają się, a następnie ponownie się pogarszają
  • Pojawiają się silne bóle głowy lub ból twarzy
  • Gorączka utrzymuje się dłużej niż 3-4 dni
  • Występuje utrata widzenia, splątanie lub zawroty głowy wraz z objawami zapalenia zatok64

W przypadku nawracającego zapalenia zatok (więcej niż 4 epizody w ciągu roku) lub objawów utrzymujących się dłużej niż 12 tygodni, lekarz może skierować pacjenta do specjalisty laryngologa6566.

Aktualne badania i obserwacje

Najnowsze badania wskazują na interesujące powiązania między przewlekłym zapaleniem zatok a funkcjami poznawczymi mózgu67. Przewlekłe zapalenie zatok dotyka około 11% dorosłych w Stanach Zjednoczonych i może wymagać leczenia przez wiele lat, zazwyczaj z wykorzystaniem antybiotyków.

Badania z wykorzystaniem skanów mózgu wykazały, że nawet u młodych osób z umiarkowanym i ciężkim zapaleniem zatok, bez klinicznych objawów upośledzenia funkcji poznawczych, występują subtelne zmiany w komunikacji między regionami mózgu odpowiedzialnymi za uwagę, koncentrację i sen68.

Istnieje możliwość, że te zmiany mogą powodować bardziej znaczące klinicznie objawy, jeśli przewlekłe zapalenie zatok pozostanie nieleczone. Zmiany te mogą być wczesnymi markerami pogorszenia funkcji poznawczych, gdzie zapalenie zatok działa jako czynnik wywołujący lub predykcyjny69.

Obserwacje te podkreślają znaczenie wczesnego rozpoznania i skutecznego leczenia przewlekłego zapalenia zatok, nie tylko dla złagodzenia objawów związanych z zatokami, ale również dla potencjalnego zapobiegania długoterminowym skutkom poznawczym.

Kolejne rozdziały

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Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Chronic sinusitis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661
    Chronic sinusitis causes the spaces inside the nose and head, called sinuses, to become inflamed and swollen. The condition lasts 12 weeks or longer, even with treatment. […] Symptoms might include a blocked or stuffy nose that makes it hard to breathe through the nose and pain and swelling around the eyes, cheeks, nose or forehead. […] Common symptoms of chronic sinusitis include: Thick, discolored mucus from the nose, known as a runny nose. Mucus down the back of the throat, known as postnasal drip. Blocked or stuffy nose, known as congestion. This makes it hard to breathe through the nose. Pain, tenderness and swelling around the eyes, cheeks, nose or forehead. Reduced sense of smell and taste. […] The symptoms of chronic sinusitis last at least 12 weeks. There might be many bouts of acute sinusitis before it becomes chronic sinusitis. Fever isn’t common with chronic sinusitis. But fever might be part of acute sinusitis.
  • #2 Chronic Sinusitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17700-chronic-sinusitis
    Chronic sinusitis is inflammation in your sinuses or a sinus infection, with symptoms that dont go away within 12 weeks. Symptoms include facial pain, post-nasal drip and thick yellow or green mucus in your nose. […] Chronic sinusitis is long-lasting swelling or infection in your sinuses. Unlike acute sinusitis, which typically goes away within 10 days, chronic sinusitis may last 12 weeks or more. […] If you have chronic sinusitis, you may feel: Tenderness or pressure, particularly around your nose, eyes and forehead. Thick yellow or green mucus from your nose or postnasal drip (mucus that builds up and drips down the back of your throat). Stuffy nose. Toothache. Headache, particularly a headache that makes your face hurt. Cough. Tiredness. Ear pain. Loss of the senses of taste (ageusia) and smell (anosmia). Bad breath (halitosis).
  • #3 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is diagnosed when at least two of the following four symptoms are present and occur for more than 12 weeks: (1) purulent drainage, (2) facial and/or dental pain, (3) nasal obstruction, (4) hyposmia. […] Chronic sinusitis lasts twelve weeks or longer. […] Chronic sinusitis may be a benign disorder, but it has significant morbidity. If not treated, the quality of life is poor. The condition is known to exacerbate asthma and can even lead to meningitis and brain abscess formation- which increases morbidity and mortality. Patients with chronic sinusitis who are treated usually have satisfactory outcomes. Symptom relief can be obtained after functional endoscopic sinus surgery in about 75% of patients who fail to respond to medical management. In rare cases, chronic sinusitis can result in orbital and intracranial infections, leading to visual and neurological deficits.
  • #4 Chronic Rhinosinusitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1015/p500.html
    Chronic rhinosinusitis is defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 consecutive weeks, in addition to objective evidence. […] The greatest impact of chronic rhinosinusitis is decreased quality of life through burdensome chronic sinonasal symptoms and acute exacerbations. […] Chronic rhinosinusitis is diagnosed clinically with a physical examination and focused sinonasal history, including chronic rhinosinusitis-associated comorbidities and a pertinent family history. […] Of the four cardinal symptoms used for diagnosis, nasal obstruction is most common (81% to 95% of patients), followed by facial pressure (70% to 85%), discolored nasal drainage (51% to 83%), and hyposmia (61% to 69%).
  • #5 Patient education: Chronic rhinosinusitis (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/chronic-rhinosinusitis-beyond-the-basics
    Chronic rhinosinusitis is considered chronic when it lasts at least three months. […] People with rhinosinusitis have at least two of the following symptoms: Nasal congestion, Mucus discharge from the nose or mucus that drips down the back of the throat, Facial pain, pressure, or „fullness”, A decreased sense of smell. […] As noted above, the symptoms of chronic rhinosinusitis must include two or more of the following: Nasal congestion or blockage, Mucus discharge from the nose or mucus that drips down the back of the throat (postnasal drip), Facial pain, pressure, or „fullness”, A decreased sense of smell. […] Young children may have other symptoms, including chronic cough and halitosis (bad breath). Many people with chronic rhinosinusitis also experience fatigue, although this symptom is not used to diagnose chronic rhinosinusitis, because there are many other causes of fatigue unrelated to sinus conditions. Still, fatigue is a prominent symptom in some patients with chronic rhinosinusitis, and it can be the most difficult symptom for some people to manage. […] Chronic rhinosinusitis is likely if a person has had two or more of the symptoms listed above for a period of at least three months. In addition, there should be evidence of sinus disease that can be seen on a sinus computed tomography (CT) scan or with a procedure called nasal endoscopy.
  • #6 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is an inflammation of the sinus or nasal passages occurring for more than 12 weeks at a time. Patients present with the cardinal symptoms of sinusitis which are purulent nasal discharge, facial or dental pain, and nasal obstruction. […] Chronic sinusitis may present as (1) chronic sinusitis without nasal polyps, (2) chronic sinusitis with nasal polyps, and (3) allergic fungal rhinosinusitis. […] The three cardinal symptoms of sinusitis are: 1) Purulent drainage: green or yellow nasal discharge 2) Facial/dental pain: aching, fullness or pressure-like pain 3) Nasal obstruction: this can cause difficulty breathing from one or both nasal passages or cause mouth breathing. Other symptoms of chronic sinusitis include hyposmia (decreased sense of smell), headache, ear pain, halitosis (bad breath), dental pain, cough, or fatigue. The duration of symptoms is the key factor in diagnosing chronic sinusitis. Symptoms should occur for more than 12 weeks.
  • #7 Sinusitis Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/sinusitis
    Chronic sinusitis is when the symptoms and swelling of the sinuses is present for longer than 3 months. It may be caused by bacteria or a fungus. […] Symptoms of chronic sinusitis are the same as those of acute sinusitis. However, the symptoms tend to be milder and last longer than 12 weeks. […] Chronic sinusitis should be treated for 3 to 4 weeks.
  • #8 Chronic sinusitis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661
    Chronic sinusitis causes the spaces inside the nose and head, called sinuses, to become inflamed and swollen. The condition lasts 12 weeks or longer, even with treatment. […] Symptoms might include a blocked or stuffy nose that makes it hard to breathe through the nose and pain and swelling around the eyes, cheeks, nose or forehead. […] Common symptoms of chronic sinusitis include: Thick, discolored mucus from the nose, known as a runny nose. Mucus down the back of the throat, known as postnasal drip. Blocked or stuffy nose, known as congestion. This makes it hard to breathe through the nose. Pain, tenderness and swelling around the eyes, cheeks, nose or forehead. Reduced sense of smell and taste. […] The symptoms of chronic sinusitis last at least 12 weeks. There might be many bouts of acute sinusitis before it becomes chronic sinusitis. Fever isn’t common with chronic sinusitis. But fever might be part of acute sinusitis.
  • #9 Chronic Sinusitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17700-chronic-sinusitis
    Chronic sinusitis is inflammation in your sinuses or a sinus infection, with symptoms that dont go away within 12 weeks. Symptoms include facial pain, post-nasal drip and thick yellow or green mucus in your nose. […] Chronic sinusitis is long-lasting swelling or infection in your sinuses. Unlike acute sinusitis, which typically goes away within 10 days, chronic sinusitis may last 12 weeks or more. […] If you have chronic sinusitis, you may feel: Tenderness or pressure, particularly around your nose, eyes and forehead. Thick yellow or green mucus from your nose or postnasal drip (mucus that builds up and drips down the back of your throat). Stuffy nose. Toothache. Headache, particularly a headache that makes your face hurt. Cough. Tiredness. Ear pain. Loss of the senses of taste (ageusia) and smell (anosmia). Bad breath (halitosis).
  • #10 Long Term Effects of Chronic Sinusitis – SinusDoctor
    https://www.sinusdoctor.com/long-term-effects-of-chronic-sinusitis/
    Chronic sinusitis is a condition marked by long-lasting inflammation and infection of the sinuses, persisting for more than 12 weeks. The sinuses, which are air-filled spaces in the face and head, become swollen and obstructed, resulting in symptoms such as nasal congestion, difficulty breathing through the nose, and facial tenderness. […] Symptoms of chronic sinusitis include facial tenderness or pressure, postnasal drip (drainage down the throat), nasal discharge or stuffy nose, toothache, ear pain, headache, cough and tiredness, loss of taste and smell, halitosis (bad breath), nasal inflammation and runny nose, sore throat and fatigue, yellow or green mucus from the nose, nausea, and nighttime coughing. […] Symptoms of chronic sinusitis have the potential to persist for extended periods, ranging from months to even years. In medical practice, healthcare providers often classify sinusitis as chronic rather than acute if the symptoms continue for a minimum of three months. This duration helps differentiate between acute and chronic cases of sinusitis.
  • #11 10 Signs You Have a Sinus Infection – Chicago ENT
    https://chicagoent.com/nose/10-signs-you-have-a-sinus-infection/
    Are you experiencing pressure around your nose, forehead, and eyes? Does your face feel like its overly full? […] These are some of the more common signs of having a sinus infection. […] Your nasal passages can become narrowed when theyre swollen or inflamed due to a sinus infection, making it harder to breathe. As a result, you may find it difficult to sleep comfortably at night. […] Another symptom of a sinus infection is thick nasal discharge. The discharge may be yellowish, greenish, or cloudy-looking with some traces of blood. […] When the sinuses become inflamed and produce excess mucus, this mucus can drip down the back of the throat, irritating it and triggering a cough reflex. […] Ear pain is a frequent symptom associated with sinus infections. […] Dental and facial pain frequently accompanies sinus infections. Symptoms typically include pain, pressure, or a throbbing sensation localized around the forehead, neck, between the eyes, and in the upper jaw.
  • #12 6 Common Symptoms of Chronic Sinusitis To Watch Out For
    https://www.houstonent.com/blog/6-common-symptoms-of-chronic-sinusitis
    Chronic sinusitis can display symptoms such as: […] The spaces inside your head and nose (sinuses) become inflamed and swollen for more than three months despite treatment. This inflammation interferes with the normal drainage of your mucus, making your nose stuffy. It can be difficult to breathe through your nose and the area around your eyes may feel tender and swollen. […] Sinusitis often presents nasal discharge as your mucous membrane of your sinuses and nose are attached. The drainage can be: […] The fluid trickling down your throat can cause irritation (particularly over a long period of time) and produces a cough. […] The inflamed sinuses can impact your breathing. It’s harder for air to travel past because of the swelling of your nasal and sinus passages. This can affect your sense of taste and smell and make it hard to breathe through your nose.
  • #13 Sinus Infection (Sinusitis): Symptoms & Causes | NewYork-Presbyterian
    https://www.nyp.org/primary-care/sinusitis-sinus-infections
    Chronic sinusitis. With chronic, or long-term, sinusitis, the linings of the sinuses are swollen for 12 weeks or more. Symptoms of chronic sinusitis include nasal congestion, facial pain or pressure, and decreased sense of smell. […] Symptoms of sinusitis, both acute (lasting 10 days to four weeks) and chronic (lasting 12 weeks or more) can include: Runny nose, Congestion (stuffy nose), Yellow or green discharge from nose, Post-nasal drip, Headache, Pain and pressure in the face, Cough, Tooth pain, Reduced sense of taste or smell, Bad breath, Fever, Fatigue.
  • #14 Chronic sinusitis vs. stuffy nose – Mayo Clinic Health System
    https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/chronic-sinusitis-more-than-a-stuffy-nose
    Chronic sinusitis is a long-lasting form of sinusitis, and it is diagnosed when symptoms persist for longer than three months. […] Acute sinusitis can turn into a chronic condition if you have had sinusitis multiple times, have infections that don’t respond to treatment or you have sinusitis symptoms that last more than three months. […] Common causes of chronic sinusitis include nasal polyps; deviated nasal septum; complications of conditions, such as cystic fibrosis, HIV and other diseases related to the immune system; recurrent respiratory infections; or allergies. […] Common signs and symptoms of sinusitis include: Thick, discolored discharge, or mucus, from the nose; Drainage down the back of the throat, which also is known as postnasal drainage; Nasal obstruction or congestion, causing difficulty breathing through your nose; Pain, pressure, fullness or tenderness, and swelling around your eyes, cheeks, nose or forehead; Reduced sense of smell and taste. […] Other less common symptoms can include: Cough or frequent throat clearing; Fatigue; Ear pain or pressure; Dental pain; Nasal or throat irritation; Bad breath; Headache; Voice hoarseness.
  • #15 How To Tell If You Have Chronic Sinus Disease | Bernstein Clinic
    https://www.bernsteinallergyresearch.com/clinic/blog/2023/01/09/how-to-tell-if-you-have-chronic-sinus-disease/
    Common signs of chronic sinusitis include persistent nasal inflammation, thick/discolored discharge, and pain or pressure around your eyes, cheeks, nose or forehead. Other symptoms include a reduced sense of smell and taste, bad breath, dental pain, headaches, fatigue, coughing, congestion and postnasal drip. […] People with chronic sinus disease often suffer from fatigue or depression due to their symptoms, and may also have difficulty concentrating. If you’ve noticed that your energy levels are lower than normal or that you’re feeling off, it could be related to chronic sinusitis. […] If you are frequently experiencing sinus pain, pressure, or congestion that doesn’t seem to go away, you may have chronic sinusitis. This is a serious condition that can lead to major health complications if left untreated.
  • #16 Chronic Sinusitis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/232791-overview
    Chronic sinusitis is an inflammatory process involving the paranasal sinus and persisting for at least 12 weeks. […] Symptoms of CRS include the following: Nasal obstruction, blockage, congestion, or stuffiness; nasal discharge (any); postnasal drip; sneezing. […] Chronic sinusitis may manifest as one of three major clinical syndromes: CRS without nasal polyps, CRS with nasal polyps, or allergic fungal rhinosinusitis. […] Although most cases of CRS result from unresolved acute sinusitis, the two conditions have different manifestations. CRS often develops gradually over months or years, but it may begin suddenly as an upper respiratory tract infection or acute sinusitis that fails to resolve. […] Most cases of chronic sinusitis are continuations of unresolved acute sinusitis; however, chronic sinusitis usually manifests differently from acute sinusitis. Symptoms of chronic sinusitis include nasal stuffiness, postnasal drip, facial fullness, and malaise.
  • #17 Chronic sinusitis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661
    Chronic sinusitis causes the spaces inside the nose and head, called sinuses, to become inflamed and swollen. The condition lasts 12 weeks or longer, even with treatment. […] Symptoms might include a blocked or stuffy nose that makes it hard to breathe through the nose and pain and swelling around the eyes, cheeks, nose or forehead. […] Common symptoms of chronic sinusitis include: Thick, discolored mucus from the nose, known as a runny nose. Mucus down the back of the throat, known as postnasal drip. Blocked or stuffy nose, known as congestion. This makes it hard to breathe through the nose. Pain, tenderness and swelling around the eyes, cheeks, nose or forehead. Reduced sense of smell and taste. […] The symptoms of chronic sinusitis last at least 12 weeks. There might be many bouts of acute sinusitis before it becomes chronic sinusitis. Fever isn’t common with chronic sinusitis. But fever might be part of acute sinusitis.
  • #18
    https://www.theballoondoc.com/common-symptoms-of-chronic-sinusitis
    While these signs and symptoms also could be linked to acute sinusitis, it is important to note that acute sinusitis is a temporary condition that is usually linked to a cold or virus and may even come with a fever. This form typically will last a few weeks and can usually be relieved with over the counter medicine or low dosage prescriptions. If acute sinusitis is something that occurs frequently or perhaps had several episodes within the past year, it may be time to visit a doctor, as it could lead to chronic sinusitis. This condition can be brought on by a few different factors. It could have been brought on by an respiratory tract infection, either viral, fungal or bacterial, which can inflame and thicken sinus membranes and block drainage. Allergies such as hay fever, can also cause inflammation and blockage of sinuses. Nasal polyps, which are tissue growths in the sinuses that can black nasal passages from selling of the sinus lining. A deviated nasal spectrum, or crooked septum (wall between the nostrils) which can restrict or block nasal and sinus passages causing symptoms to worsen. Other medical condition such as cystic fibrosis, HIV and other related immune system diseases can complicate conditions and lead to nasal blockage as well. […] Chronic vs. Acute Sinusitis While acute sinusitis typically lasts less than four weeks and may follow a cold or respiratory infection, chronic sinusitis persists beyond 12 weeks despite treatment efforts.
  • #19 Sinusitis: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000647.htm
    Sinusitis can occur from one of these conditions: […] Chronic sinusitis is when the symptoms and swelling of the sinuses is present for longer than 3 months. It may be caused by bacteria or a fungus. […] Symptoms of chronic sinusitis are the same as those of acute sinusitis. However, the symptoms tend to be milder and last longer than 12 weeks.
  • #20 Sinus infection: 11 symptoms and treatments
    https://www.medicalnewstoday.com/articles/322108
    Sinusitis tends to last longer than a cold. Cold symptoms tend to get steadily worse, peaking at 35 days, then gradually get better. Sinus infections may last 10 days or more. […] Unlike a cold, sinusitis can become chronic, which means it lasts longer than eight weeks. Chronic sinusitis causes swelling and irritation in the sinuses and usually develops after a person has had acute sinusitis. Sometimes the symptoms go away and then come back again. […] Ongoing sinus symptoms even if they get better and then come back may indicate chronic sinusitis. […] The outlook for most cases of sinusitis is good. Sinus infections often clear up on their own within a week or two. When they do not, the infection may be bacterial, and antibiotics can help. […] However, if the infection does not get better after three months, a doctor might refer someone to an ear, nose, and throat specialist who can identify and treat the underlying cause of chronic sinusitis.
  • #21 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is an inflammation of the sinus or nasal passages occurring for more than 12 weeks at a time. Patients present with the cardinal symptoms of sinusitis which are purulent nasal discharge, facial or dental pain, and nasal obstruction. […] Chronic sinusitis may present as (1) chronic sinusitis without nasal polyps, (2) chronic sinusitis with nasal polyps, and (3) allergic fungal rhinosinusitis. […] The three cardinal symptoms of sinusitis are: 1) Purulent drainage: green or yellow nasal discharge 2) Facial/dental pain: aching, fullness or pressure-like pain 3) Nasal obstruction: this can cause difficulty breathing from one or both nasal passages or cause mouth breathing. Other symptoms of chronic sinusitis include hyposmia (decreased sense of smell), headache, ear pain, halitosis (bad breath), dental pain, cough, or fatigue. The duration of symptoms is the key factor in diagnosing chronic sinusitis. Symptoms should occur for more than 12 weeks.
  • #22 Chronic Sinusitis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/232791-overview
    Chronic sinusitis is an inflammatory process involving the paranasal sinus and persisting for at least 12 weeks. […] Symptoms of CRS include the following: Nasal obstruction, blockage, congestion, or stuffiness; nasal discharge (any); postnasal drip; sneezing. […] Chronic sinusitis may manifest as one of three major clinical syndromes: CRS without nasal polyps, CRS with nasal polyps, or allergic fungal rhinosinusitis. […] Although most cases of CRS result from unresolved acute sinusitis, the two conditions have different manifestations. CRS often develops gradually over months or years, but it may begin suddenly as an upper respiratory tract infection or acute sinusitis that fails to resolve. […] Most cases of chronic sinusitis are continuations of unresolved acute sinusitis; however, chronic sinusitis usually manifests differently from acute sinusitis. Symptoms of chronic sinusitis include nasal stuffiness, postnasal drip, facial fullness, and malaise.
  • #23
    https://www.gleneagles.com.sg/conditions-diseases/sinusitis/symptoms-causes
    Chronic sinusitis is also known as chronic rhinosinusitis (CRS). The change from acute to chronic sinusitis is a gradual process of persisting sinus inflammation. Symptoms must be present for at least 12 weeks. […] CRS can be broadly classified into 2 types, with possible overlapping of features: CRS without nasal polyposis (CRSwoNP) […] CRS with nasal polyposis (CRSwNP) Nasal polyps represent severe swelling of the sinus mucosa. CRSwNP is usually caused by an underlying immune dysfunction that leads to an excessive inflammatory response. The chronic buildup of symptoms typically causes a loss of smell, and sometimes facial pain. […] The symptoms of sinusitis include: […] In addition, you may experience a reduced sense of smell and taste, tiredness, fever or a sense of general malaise.
  • #24 10 Things to Know About Sinusitis – Keck Medicine of USC
    https://www.keckmedicine.org/blog/10-things-to-know-about-sinusitis/
    Chronic sinusitis, on the other hand, lasts for more than 12 weeks, despite medical treatment. […] People with allergic rhinitis or asthma may be more prone to chronic sinusitis, which also can be due to infection, allergies, a fungus or, in rare cases, an immune system deficiency. […] Nasal polyps or structural problems in the nasal passages can also lead to a chronic sinusitis.
  • #25 Chronic Sinusitis: Causes, Symptoms, and Treatment
    https://patient.info/ears-nose-throat-mouth/acute-sinusitis/chronic-sinusitis
    Chronic sinusitis is inflammation of the sinuses that lasts a long time, usually defined as 12 weeks or more. […] Chronic sinusitis usually happens at the same time as chronic rhinitis (inflammation of the nose). The combination is called chronic rhinosinusitis. […] Common symptoms of chronic sinusitis include: A blocked or congested nose. A runny nose. The discharge may be green/yellow. A reduced, or absent, sense of smell. Pain or a pressure feeling over the affected sinuses. […] These symptoms are similar to acute sinusitis, but, in chronic sinusitis, they last for longer (12 weeks or more). In chronic sinusitis, symptoms can wax and wane over time – improving or worsening at different times.
  • #26 Sinus Infection (Sinusitis): Symptoms, Causes, Duration, and Treatment
    https://www.webmd.com/allergies/sinusitis-and-sinus-infection
    Chronic sinusitis brings on the same unpleasant symptoms as acute sinusitis. But it lasts a whole lot longer. You won’t be diagnosed with chronic sinusitis until you’ve had symptoms for at least 3 months. […] In order to receive a diagnosis of chronic sinusitis, your symptoms must last at least 12 weeks, or 3 months. Unfortunately, you may experience symptoms for much longer. Some research has found that symptoms can linger for more than a decade. They may improve over time, but they don’t always go away completely.
  • #27 Chronic Rhinosinusitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1015/p500.html
    The goals of treatment in patients with chronic rhinosinusitis are to manage symptoms and improve or maintain quality of life. […] Endoscopic sinus surgery is an effective treatment of chronic rhinosinusitis when appropriate medical therapy is ineffective. […] Like asthma, the natural history of chronic rhinosinusitis includes acute exacerbations.
  • #28 Chronic Sinusitis: 5 Ways to Cope with the Symptoms | BASS Medical Group
    https://www.bassmedicalgroup.com/blog-post/5-ways-to-cope-with-chronic-sinusitis-symptoms
    Chronic sinusitis is more than just an occasional stuffy noseits a long-term condition that can cause persistent sinus pain, pressure, and fatigue. If youve been feeling run-down, congested, or battling a sore face and head, youre not alone. Millions of people deal with chronic sinusitis symptoms daily. […] Common chronic sinusitis symptoms include: Persistent nasal congestion, Thick nasal discharge, Facial pressure or pain, Jaw or tooth pain, Ear fullness or discomfort, Sore throat or postnasal drip, Chronic fatigue. […] If youve been struggling with sinus pressure, headaches, or nasal congestion for months, chronic sinusitis could be the cause. Ignoring your symptoms may lead to further complications like sleep problems or frequent infections.
  • #29 Patient education: Chronic rhinosinusitis (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/chronic-rhinosinusitis-beyond-the-basics
    Chronic rhinosinusitis is considered chronic when it lasts at least three months. […] People with rhinosinusitis have at least two of the following symptoms: Nasal congestion, Mucus discharge from the nose or mucus that drips down the back of the throat, Facial pain, pressure, or „fullness”, A decreased sense of smell. […] As noted above, the symptoms of chronic rhinosinusitis must include two or more of the following: Nasal congestion or blockage, Mucus discharge from the nose or mucus that drips down the back of the throat (postnasal drip), Facial pain, pressure, or „fullness”, A decreased sense of smell. […] Young children may have other symptoms, including chronic cough and halitosis (bad breath). Many people with chronic rhinosinusitis also experience fatigue, although this symptom is not used to diagnose chronic rhinosinusitis, because there are many other causes of fatigue unrelated to sinus conditions. Still, fatigue is a prominent symptom in some patients with chronic rhinosinusitis, and it can be the most difficult symptom for some people to manage. […] Chronic rhinosinusitis is likely if a person has had two or more of the symptoms listed above for a period of at least three months. In addition, there should be evidence of sinus disease that can be seen on a sinus computed tomography (CT) scan or with a procedure called nasal endoscopy.
  • #30 Sinusitis – Whole Health Library
    https://www.va.gov/WHOLEHEALTHLIBRARY/tools/sinusitis.asp
    Chronic: Symptoms lasting eight weeks or longer and of varying severity. Symptoms are typically similar to acute sinusitis, but often, more fatigue is present. […] Symptoms of sinusitis often include thick nasal drainage, bad-tasting postnasal drip, nasal and head congestion, cough, difficulty breathing, headache, facial swelling, toothache, fatigue, tender cheeks, swollen eyelids, and sometimes fever. […] Chronic, untreated allergic rhinitis also increases the risk of sinusitis. […] Sleep deprivation also leads to decreased response to immunizations, such as the influenza vaccine. In contrast, adequate sleep strengthens the immune response; most immune cells response to challenges (e.g., viral infections) peak at night. […] Conversely, for a number of reasons, those with chronic sinus symptoms tend to have more sleep dysfunction. This may be partly due to the inflammatory disease process and partly due to the mechanical impact of the disease on nighttime breathing. […] Supporting patients in finding paths to understand the relationship between chronic stress and mental health and physical symptoms is an important and, at times, challenging part of fostering true well-being.
  • #31 6 Common Symptoms of Chronic Sinusitis To Watch Out For
    https://www.houstonent.com/blog/6-common-symptoms-of-chronic-sinusitis
    Sinus pressure/pain is something many experience with sinusitis. You might feel the pain: […] Sense of smell is an especially essential thing to address and unfortunately, it’s frequently not addressed. Changes in smell/taste or loss of taste and smell because of sinusitis can be extremely frustrating, particularly when there’s a lot going on in your life. […] Many individuals with sinusitis will stress to you chronic sinusitis is no minor thing at all. It’s long-term symptoms can lead to fatigue with possible depression or can worsen depression in a few ways: […] When you’re experiencing both full-blown depression and chronic sinusitis, they can fuel one another and make your symptoms worse. Therefore, treating just one of these conditions might not provide you with total relief. You might have to obtain a professional diagnosis and receive treatment for both of these conditions to feel your best.
  • #32 Chronic Sinusitis | University of Utah Health
    https://healthcare.utah.edu/ent/treatments-services/rhinology-sinus/sinusitis
    Chronic sinusitis interferes with that. It occurs when the sinuses become inflamed and blocked for 12 weeks or longer, despite treatment. This can make it difficult to breathe freely, sleep well, and even think clearly. […] Common symptoms of chronic sinusitis include: difficulty breathing through your nose, difficulty sleeping due to breathing discomfort, increased mucus in your sinuses and nose, inflammation (swelling) in your nose (nasal congestion), loss of smell and taste, pain in your ears, upper jaw, and teeth, and post-nasal drip (when mucus drains down the back of your throat). […] The symptoms of acute sinusitis are similar to those of chronic sinusitis but only last for a short time. […] If you experience symptoms of sinusitis for more than 10 days, consider making an appointment with your primary care provider.
  • #33 6 Common Symptoms of Chronic Sinusitis To Watch Out For
    https://www.houstonent.com/blog/6-common-symptoms-of-chronic-sinusitis
    Sinus pressure/pain is something many experience with sinusitis. You might feel the pain: […] Sense of smell is an especially essential thing to address and unfortunately, it’s frequently not addressed. Changes in smell/taste or loss of taste and smell because of sinusitis can be extremely frustrating, particularly when there’s a lot going on in your life. […] Many individuals with sinusitis will stress to you chronic sinusitis is no minor thing at all. It’s long-term symptoms can lead to fatigue with possible depression or can worsen depression in a few ways: […] When you’re experiencing both full-blown depression and chronic sinusitis, they can fuel one another and make your symptoms worse. Therefore, treating just one of these conditions might not provide you with total relief. You might have to obtain a professional diagnosis and receive treatment for both of these conditions to feel your best.
  • #34 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is diagnosed when at least two of the following four symptoms are present and occur for more than 12 weeks: (1) purulent drainage, (2) facial and/or dental pain, (3) nasal obstruction, (4) hyposmia. […] Chronic sinusitis lasts twelve weeks or longer. […] Chronic sinusitis may be a benign disorder, but it has significant morbidity. If not treated, the quality of life is poor. The condition is known to exacerbate asthma and can even lead to meningitis and brain abscess formation- which increases morbidity and mortality. Patients with chronic sinusitis who are treated usually have satisfactory outcomes. Symptom relief can be obtained after functional endoscopic sinus surgery in about 75% of patients who fail to respond to medical management. In rare cases, chronic sinusitis can result in orbital and intracranial infections, leading to visual and neurological deficits.
  • #35 Chronic Sinusitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17700-chronic-sinusitis
    Untreated chronic sinusitis may cause infections that spread from your sinuses into your eyes, bones, brain or spine. […] If sinus infection symptoms last 12 weeks or more, healthcare providers may determine that you have chronic sinusitis. […] Chronic sinusitis treatment focuses on controlling or easing inflammation. […] Yes, it can, depending on the cause. For example, if nasal polyps cause chronic sinusitis, removing the polyps could cure the condition. […] If youve had sinusitis symptoms for weeks, its time to contact a healthcare provider. Sinusitis symptoms include thick green or yellow mucus from your nose, or it hurts when you put gentle pressure on your nose, forehead or around your eyes. […] Chronic sinusitis is different from recurrent sinusitis because chronic sinusitis symptoms dont go away for long periods of time. In recurrent sinusitis, you have four or more bouts of sinusitis in one year, but you also have symptom-free periods in between.
  • #36 What Happens to an Untreated Sinus Infection? | Kaplan Sinus ReliefExitFacebookTwitterLinkedinMailYoutubeFacebook
    https://www.kaplansinusrelief.com/blog/dangers-chronic-untreated-sinusitis-complications/
    A paranasal sinus mucocele is another potential complication of an untreated sinus infection. […] The longer a sinus infection goes untreated, the higher the risk of it spreading to other areas. […] Orbital cellulitis is a bacterial infection of the eye socket that can result from an untreated sinus infection. […] The most rare yet most severe complications of an untreated sinus infection are meningitis and brain abscess. […] In rare cases, an untreated sinus infection can lead to a serious condition called sinus thrombosis. […] While chronic sinusitis itself is not life-threatening, untreated sinus infections can lead to severe complications. If you suffer from chronic or frequent sinus infections, it’s crucial to seek medical treatment to prevent any potential long-term consequences.
  • #37 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is diagnosed when at least two of the following four symptoms are present and occur for more than 12 weeks: (1) purulent drainage, (2) facial and/or dental pain, (3) nasal obstruction, (4) hyposmia. […] Chronic sinusitis lasts twelve weeks or longer. […] Chronic sinusitis may be a benign disorder, but it has significant morbidity. If not treated, the quality of life is poor. The condition is known to exacerbate asthma and can even lead to meningitis and brain abscess formation- which increases morbidity and mortality. Patients with chronic sinusitis who are treated usually have satisfactory outcomes. Symptom relief can be obtained after functional endoscopic sinus surgery in about 75% of patients who fail to respond to medical management. In rare cases, chronic sinusitis can result in orbital and intracranial infections, leading to visual and neurological deficits.
  • #38 What Happens to an Untreated Sinus Infection? | Kaplan Sinus ReliefExitFacebookTwitterLinkedinMailYoutubeFacebook
    https://www.kaplansinusrelief.com/blog/dangers-chronic-untreated-sinusitis-complications/
    A paranasal sinus mucocele is another potential complication of an untreated sinus infection. […] The longer a sinus infection goes untreated, the higher the risk of it spreading to other areas. […] Orbital cellulitis is a bacterial infection of the eye socket that can result from an untreated sinus infection. […] The most rare yet most severe complications of an untreated sinus infection are meningitis and brain abscess. […] In rare cases, an untreated sinus infection can lead to a serious condition called sinus thrombosis. […] While chronic sinusitis itself is not life-threatening, untreated sinus infections can lead to severe complications. If you suffer from chronic or frequent sinus infections, it’s crucial to seek medical treatment to prevent any potential long-term consequences.
  • #39 The 4 Main Symptoms of Sinusitis (Sinus Infection), Causes, Treatment
    https://www.emedicinehealth.com/what_are_the_4_main_symptoms_of_sinusitis/article_em.htm
    Sick woman lying on a couch and pinching her nose due to sinus pain, one of the symptoms of sinusitis. The four main symptoms of acute sinusitis include runny or stuffy nose, postnasal drip, congestion, and pain or pressure feeling in the face. […] Symptoms of chronic sinusitis may include those of acute sinusitis, but the symptoms last longer and/or are more severe. Additional symptoms of chronic sinusitis may include: […] Pain/pressure in the face that worsens […] Increased cough at night […] Increased facial discomfort throughout the day […] Chronic sore throat […] Chronic bad breath (halitosis) […] Chronic toothache or increased tooth sensitivity.
  • #40
    https://www.gleneagles.com.sg/conditions-diseases/sinusitis/symptoms-causes
    Persistent sinusitis (e.g. for more than 1 month) […] If you experience any of the following symptoms, you should consult an ENT specialist immediately, as they may suggest severe complications of sinusitis (e.g. infection spreading to the eyes or brain): […] Sinus infection can spread to the eyes. In the early stages, the eyelids may become swollen. As the infection progresses, the eye itself becomes swollen and painful. The structures of the eye may be damaged and result in vision problems such as double vision or blindness. […] Infection of the sinuses may spread to the meninges (membranes surrounding your brain). Classic symptoms of a meningeal infection include high fever, headache and neck stiffness, and altered neurological function. Further bacterial spread can lead to the formation of brain abscesses (accumulation of pus and breakdown products from infection). The swelling and pressure of the brain tissue can cause neurological deficits and coma.
  • #41 Common Symptoms of Chronic Sinusitis to Watch Out For: Steven D. Kushnick, MD: ENT
    https://www.stevenkushnickmd.com/blog/common-symptoms-of-chronic-sinusitis-to-watch-out-for
    If you experience symptoms that linger for weeks, you might have chronic sinusitis. […] Its important to seek treatment early if you suspect you have chronic sinusitis. Allowing an infection to linger can lead to serious vision problems and even blindness if the infection spreads to your eye socket. […] An untreated infection can also move into the membranes and fluid that protect your spinal cord and brain. This is meningitis, and while its rare, it is potentially deadly.
  • #42 Sinusitis (Sinus Infection) Types, Causes, Symptoms, Treatment
    https://www.medicinenet.com/sinusitis/article.htm
    The signs and symptoms of chronic sinusitis last at least three months or longer. Patients may experience multiple flare-ups of acute sinusitis. […] Potential complications of untreated sinus infection include: Chronic sinusitis, Difficulty breathing, Hyposmia (reduced sense of smell), Anosmia (complete loss of the sense of smell), Laryngitis (inflammation of the larynx), Dacryocystitis (inflammation or infection of the lacrimal glands), Orbital cellulitis or abscess (inflammation of the orbit of the eye), Meningitis (inflammation of the meninges), Brain abscess (pus-filled pockets inside the brain), Frontal bone osteomyelitis (infection of the frontal bone), Cavernous sinus thrombosis (formation of blood clot forms inside a hollow space at the base of the brain). […] While serious complications are uncommon, it is possible for a sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergency (for example, meningitis or brain abscess).
  • #43 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is diagnosed when at least two of the following four symptoms are present and occur for more than 12 weeks: (1) purulent drainage, (2) facial and/or dental pain, (3) nasal obstruction, (4) hyposmia. […] Chronic sinusitis lasts twelve weeks or longer. […] Chronic sinusitis may be a benign disorder, but it has significant morbidity. If not treated, the quality of life is poor. The condition is known to exacerbate asthma and can even lead to meningitis and brain abscess formation- which increases morbidity and mortality. Patients with chronic sinusitis who are treated usually have satisfactory outcomes. Symptom relief can be obtained after functional endoscopic sinus surgery in about 75% of patients who fail to respond to medical management. In rare cases, chronic sinusitis can result in orbital and intracranial infections, leading to visual and neurological deficits.
  • #44 Symptoms of Chronic Sinus Infection | Sinus & Snoring Specialists
    https://www.sinussnoringent.com/blog/sinus-and-nasal/symptons-of-chronic-sinus-infection/
    Chronic Sinusitis is a totally different issue. In this condition, an episode of acute sinusitis actually failed to resolve. The infection in one or more of your sinus cavities lingers for months and is left untreated. This condition may not produce any of the typical sinus symptoms that you would normally feel in an acute sinusitis. As such you may not feel that you have a sinus infection at all. […] The symptoms of chronic sinusitis are usually secondary issues outside of the nasal and sinus area. […] Popping and pressure in your ears, difficulty clearing your ears, or fluid in your ears. […] Chronic hoarseness, throat clearing, and cough. […] Bronchitis and pneumonia. […] Chronic sore throat and recurring strep infection. […] Headache and migraines. […] Snoring and obstructive sleep apnea. […] Keep in mind that chronic sinusitis may disguise itself as many other medical complaints. If this diagnosis is not entertained and evaluated with a miniCT scan, you may continue to suffer from multiple secondary issues.
  • #45 Symptoms of Chronic Sinus Infection | Sinus & Snoring Specialists
    https://www.sinussnoringent.com/blog/sinus-and-nasal/symptons-of-chronic-sinus-infection/
    Chronic Sinusitis is a totally different issue. In this condition, an episode of acute sinusitis actually failed to resolve. The infection in one or more of your sinus cavities lingers for months and is left untreated. This condition may not produce any of the typical sinus symptoms that you would normally feel in an acute sinusitis. As such you may not feel that you have a sinus infection at all. […] The symptoms of chronic sinusitis are usually secondary issues outside of the nasal and sinus area. […] Popping and pressure in your ears, difficulty clearing your ears, or fluid in your ears. […] Chronic hoarseness, throat clearing, and cough. […] Bronchitis and pneumonia. […] Chronic sore throat and recurring strep infection. […] Headache and migraines. […] Snoring and obstructive sleep apnea. […] Keep in mind that chronic sinusitis may disguise itself as many other medical complaints. If this diagnosis is not entertained and evaluated with a miniCT scan, you may continue to suffer from multiple secondary issues.
  • #46 What is Chronic Sinusitis? Symptoms and Causes | UC Health
    https://www.uchealth.com/en/conditions/chronic-sinusitis
    Chronic sinusitis is an inflammatory condition of the sinuses, analogous to asthma of the sinuses. It is diagnosed when patients have at least 12 weeks of symptoms, such as nasal blockage, nasal drainage, facial pain or smell loss. […] If symptoms, such as nasal obstruction, nasal drainage, facial pressure and/or decreased sense of smell, last for more than 12 weeks, this is indicative of chronic sinusitis. […] The following are common signs and symptoms of chronic sinusitis: Nasal blockage. Congestion of the nasal passages. Thick, colored drainage from the nose. Thick mucus draining down the back of the throat (postnasal drainage). Facial pain and pressure. Headache and sinus pain. Loss of smell. Cough. Sore throat. […] Our research has also shown that the more severe the chronic sinusitis becomes, the more likely that patients are to experience severe lung problems. […] If medical treatments are not enough to control your symptoms of chronic sinusitis, you may be a good candidate for endoscopic sinus surgery.
  • #47 Chronic Sinusitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17700-chronic-sinusitis
    Untreated chronic sinusitis may cause infections that spread from your sinuses into your eyes, bones, brain or spine. […] If sinus infection symptoms last 12 weeks or more, healthcare providers may determine that you have chronic sinusitis. […] Chronic sinusitis treatment focuses on controlling or easing inflammation. […] Yes, it can, depending on the cause. For example, if nasal polyps cause chronic sinusitis, removing the polyps could cure the condition. […] If youve had sinusitis symptoms for weeks, its time to contact a healthcare provider. Sinusitis symptoms include thick green or yellow mucus from your nose, or it hurts when you put gentle pressure on your nose, forehead or around your eyes. […] Chronic sinusitis is different from recurrent sinusitis because chronic sinusitis symptoms dont go away for long periods of time. In recurrent sinusitis, you have four or more bouts of sinusitis in one year, but you also have symptom-free periods in between.
  • #48 Sinusitis
    https://www.aaaai.org/conditions-treatments/allergies/sinusitis
    Chronic sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment. […] Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include: Thick yellow-green nasal discharge Postnasal drip, often with a bad taste Cough Congestion Toothache In cases of acute sinusitis, a fever may develop. […] Chronic sinusitis is typically not caused by a bacterial infection, so treating the condition with antibiotics usually doesn’t help. Avoid activities and places that may aggravate your symptoms especially if your symptoms relate to an allergy.
  • #49 Sinus Infection (Sinusitis): Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/17701-sinusitis
    Chronic sinusitis symptoms last at least 12 weeks. Bacteria are usually the cause. […] Common symptoms of a sinus infection include: Postnasal drip (mucus dripping down your throat). Runny nose with thick yellow or green mucus. Stuffy nose. Facial pressure (particularly around your nose, eyes and forehead). This might get worse when you move your head around or bend over. […] Providers treat chronic sinusitis by focusing on the underlying condition. Treatments can include: Intranasal steroid sprays. Topical antihistamine sprays or oral pills. Leukotriene antagonists, like montelukast. Surgery to treat structural issues, polyps or fungal infections. […] Sinusitis usually only lasts a week to 10 days. You can usually treat it with over-the-counter medicines and at-home treatments. If you have chronic sinusitis or if it keeps coming back, there may be underlying causes that you’ll need to treat.
  • #50 Sinusitis – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/nose-and-sinus-disorders/sinusitis
    Sinusitis is defined as chronic if it has been ongoing for more than 90 days. […] Some symptoms suggest which sinus is infected: […] Acute and chronic sinusitis cause similar symptoms, including […] A person also may feel generally ill (malaise). […] Often the pain is more severe in acute sinusitis. […] People who have chronic sinusitis take the same antibiotics but for a longer period of time, typically 4 to 6 weeks.
  • #51 Sinusitis
    https://www.aaaai.org/conditions-treatments/allergies/sinusitis
    Chronic sinusitis, also referred to as chronic rhinosinusitis, is often diagnosed when symptoms have gone on for more than 12 weeks, despite medical treatment. […] Sinusitis symptoms, whether acute or chronic, frequently develop after a cold or during times of severe or ongoing allergic rhinitis symptoms. The most obvious sign of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms include: Thick yellow-green nasal discharge Postnasal drip, often with a bad taste Cough Congestion Toothache In cases of acute sinusitis, a fever may develop. […] Chronic sinusitis is typically not caused by a bacterial infection, so treating the condition with antibiotics usually doesn’t help. Avoid activities and places that may aggravate your symptoms especially if your symptoms relate to an allergy.
  • #52 Sinusitis – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/nose-and-paranasal-sinus-disorders/sinusitis
    Chronic sinusitis involves many factors that combine to create chronic inflammation. Chronic allergies, structural abnormalities (eg, nasal polyps), environmental irritants (eg, airborne pollution, tobacco smoke), mucociliary dysfunction, and other factors interact with infectious organisms to cause chronic sinusitis. […] Chronic sinusitis is a common incidental finding in patients who have a head CT for other reasons (eg, patients with headache with or without mild head injury) but is rarely the cause of the patient’s symptoms. […] Symptoms and signs of chronic sinusitis include purulent rhinorrhea, pressure and pain in the face, nasal congestion and obstruction, hyposmia, halitosis, and productive cough (especially at night). […] The nasal mucous membrane is red and turgescent; yellow or green purulent rhinorrhea may be present. […] Chronic sinusitis may require surgery to improve sinus drainage.
  • #53 Chronic Sinusitis | University of Utah Health
    https://healthcare.utah.edu/ent/treatments-services/rhinology-sinus/sinusitis
    In rare situations, chronic sinusitis can cause symptoms that need immediate medical attention. These occur when a bacterial infection develops in the sinuses and spreads to other parts of your body. If you experience loss of vision, confusion, or dizziness along with sinusitis symptoms, call your primary care provider right away. […] Most people with chronic sinusitis experience relief with these non-surgical treatment options. Some people need additional non-surgical therapies due to an underlying condition. […] If appropriate medical management isn’t successful, the next step may be to have endoscopic sinus surgery. This surgery opens up blocked sinuses so that they can drain better and you have better access for anti-inflammatory medicine to reach your sinuses more easily. […] Thanks to appropriate management, the majority of people with chronic sinusitis experience significant improvement in their symptoms. Patient-specific care and ongoing management of this chronic disease process are the keys to the best outcomes.
  • #54 Treatment Options for Chronic Sinusitis Symptoms
    https://www.socalsinus.com/does-chronic-sinusitis-ever-go-away/
    Chronic sinusitis lasts 12 weeks and longer. This can be worn on you physically and emotionally. […] Yes, chronic sinusitis does go away, but not on its own. […] The key to treating your chronic sinusitis might be to eliminate the cause of it. […] Sinus headaches can be unbearable. Your sinus doctor will want to help you treat the symptoms while theyre identifying the cause and helping you resolve the chronic sinus infection. […] If your chronic sinusitis is caused by a bacterial infection, antibiotics are almost always going to be the best course of treatment. […] If the cause of your chronic sinusitis is physical, such as nasal polyps or a deviated septum, you might need a surgical procedure before antibiotics and other treatments can resolve the chronic sinusitis. […] When you have nasal polyps, a polypectomy removes the polyps. This allows your sinuses to drain more easily and eliminates chronic sinusitis.
  • #55 Why Sinusitis Keeps Coming Back | Jerome Hester, MD
    https://www.drhesterent.com/why-sinusitis-keeps-coming-back/
    If the septum has deviated to the point that it causes health problems, Dr. Hester will work with you to determine which treatment method or surgical procedure is best for correcting the deviation. […] The only way to stop recurring sinus infections once and for all is to have an evaluation by a specialist who has the specialized training and experience to accurately diagnose their cause.
  • #56 Chronic Sinusitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441934/
    Chronic sinusitis is diagnosed when at least two of the following four symptoms are present and occur for more than 12 weeks: (1) purulent drainage, (2) facial and/or dental pain, (3) nasal obstruction, (4) hyposmia. […] Chronic sinusitis lasts twelve weeks or longer. […] Chronic sinusitis may be a benign disorder, but it has significant morbidity. If not treated, the quality of life is poor. The condition is known to exacerbate asthma and can even lead to meningitis and brain abscess formation- which increases morbidity and mortality. Patients with chronic sinusitis who are treated usually have satisfactory outcomes. Symptom relief can be obtained after functional endoscopic sinus surgery in about 75% of patients who fail to respond to medical management. In rare cases, chronic sinusitis can result in orbital and intracranial infections, leading to visual and neurological deficits.
  • #57 Chronic Sinusitis: Practice Essentials, Background, Anatomy
    https://emedicine.medscape.com/article/232791-overview
    Because of its persistent nature, chronic sinusitis can become a significant cause of morbidity. If left untreated, it can reduce the quality of life and the productivity of the affected person. […] Chronic sinusitis is associated with exacerbation of asthma and serious complications such as brain abscess and meningitis, which can produce significant morbidity and mortality. […] Early and aggressive medical treatment for chronic sinusitis typically results in satisfactory outcomes. Functional endoscopic sinus surgery (FESS) restores sinus health with complete or moderate relief of symptoms in 80% to 90% of patients with recurrent or medically unresponsive chronic sinusitis.
  • #58 Chronic Sinusitis (in Adults) – Harvard Health
    https://www.health.harvard.edu/a_to_z/chronic-sinusitis-in-adults-a-to-z
    Chronic sinusitis is a long-term inflammation of the sinuses. The most common symptom is painful pressure in upper parts of the face, especially in the forehead, behind the nose, between or behind the eyes, or in the cheek. Other symptoms include nasal congestion, postnasal drip that is worse at night, and bad-smelling breath that is unrelated to dental problems. Symptoms of chronic sinusitis can last for months or years. Some doctors consider sinusitis to be chronic rather than acute when it lasts at least three months. The prognosis for chronic sinusitis depends on its cause. Often medication or surgery is needed to reduce the inflammation or correct the blockage. In many cases, the inflammation has to be managed with medications for a long time to prevent recurrence.
  • #59 Chronic Sinusitis: Treatment, Symptoms, and Causes
    https://www.healthline.com/health/chronic-sinusitis
    Based on the cause of your chronic sinusitis, the symptoms may never be fully treated. You may require long-term treatment to help keep your symptoms from disrupting your daily life. […] But in many cases, your symptoms can be treated through home remedies, OTC medications, and a treatment plan developed with your doctor to address its specific causes.
  • #60 Chronic Sinusitis | University of Utah Health
    https://healthcare.utah.edu/ent/treatments-services/rhinology-sinus/sinusitis
    In rare situations, chronic sinusitis can cause symptoms that need immediate medical attention. These occur when a bacterial infection develops in the sinuses and spreads to other parts of your body. If you experience loss of vision, confusion, or dizziness along with sinusitis symptoms, call your primary care provider right away. […] Most people with chronic sinusitis experience relief with these non-surgical treatment options. Some people need additional non-surgical therapies due to an underlying condition. […] If appropriate medical management isn’t successful, the next step may be to have endoscopic sinus surgery. This surgery opens up blocked sinuses so that they can drain better and you have better access for anti-inflammatory medicine to reach your sinuses more easily. […] Thanks to appropriate management, the majority of people with chronic sinusitis experience significant improvement in their symptoms. Patient-specific care and ongoing management of this chronic disease process are the keys to the best outcomes.
  • #61 Chronic Rhinosinusitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1015/p500.html
    The goals of treatment in patients with chronic rhinosinusitis are to manage symptoms and improve or maintain quality of life. […] Endoscopic sinus surgery is an effective treatment of chronic rhinosinusitis when appropriate medical therapy is ineffective. […] Like asthma, the natural history of chronic rhinosinusitis includes acute exacerbations.
  • #62 Sinus Infection Basics | Sinus Infection | CDC
    https://www.cdc.gov/sinus-infection/about/index.html
    Runny nose […] Stuffy nose […] Facial pain or pressure […] Headache […] Mucus dripping down the throat (post-nasal drip) […] Sore throat […] Cough […] Bad breath […] When you have a sinus infection, one or more of your sinuses becomes inflamed. Fluid builds up, which can cause congestion and runny nose. […] Severe symptoms, such as severe headache or facial pain. […] Symptoms that get worse after improving. […] Symptoms lasting more than 10 days without getting better. […] Fever longer than 3-4 days. […] Multiple sinus infections in the past year. […] Most sinus infections usually get better on their own without antibiotics. […] In some cases, you may need antibiotics. […] Your healthcare provider may suggest watching and waiting for 2-3 days to see if you need antibiotics. […] If your symptoms don’t improve, the healthcare provider may prescribe an antibiotic. […] Your healthcare provider may prescribe an antibiotic but suggest that you wait 2-3 days before filling the prescription.
  • #63 Ear Nose and Throat – When to Worry About Your Lingering Sinus Infection
    https://www.entlubbock.com/blog/lingering-sinus-infection/
    Sinus infections have a way of making time stand still in a bad way. When youre constantly congested, battling headaches, and feeling sinus pressure, even a short duration of sickness can feel like its never going to end. […] If your lingering sinus infection becomes chronic, it may be time for more aggressive treatment. […] However, if you have persistent colored nasal drainage coupled with extensive symptoms like facial pressure, headache, or fever for more than 10 days, its time to see your doctor. You may be experiencing a lingering sinus infection that requires medical treatment. […] If youve been sick more than 10 days and begin to experience other symptoms like facial pressure, headache, and fever, youre dealing with more than a chronic runny nose. […] Many variables affect the duration of sinus infections. Most last more than 10 days, but when a sinus infection lasts more than twelve weeks, it is considered chronic sinusitis.
  • #64 Chronic Sinusitis | University of Utah Health
    https://healthcare.utah.edu/ent/treatments-services/rhinology-sinus/sinusitis
    In rare situations, chronic sinusitis can cause symptoms that need immediate medical attention. These occur when a bacterial infection develops in the sinuses and spreads to other parts of your body. If you experience loss of vision, confusion, or dizziness along with sinusitis symptoms, call your primary care provider right away. […] Most people with chronic sinusitis experience relief with these non-surgical treatment options. Some people need additional non-surgical therapies due to an underlying condition. […] If appropriate medical management isn’t successful, the next step may be to have endoscopic sinus surgery. This surgery opens up blocked sinuses so that they can drain better and you have better access for anti-inflammatory medicine to reach your sinuses more easily. […] Thanks to appropriate management, the majority of people with chronic sinusitis experience significant improvement in their symptoms. Patient-specific care and ongoing management of this chronic disease process are the keys to the best outcomes.
  • #65 Chronic Sinusitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/17700-chronic-sinusitis
    Untreated chronic sinusitis may cause infections that spread from your sinuses into your eyes, bones, brain or spine. […] If sinus infection symptoms last 12 weeks or more, healthcare providers may determine that you have chronic sinusitis. […] Chronic sinusitis treatment focuses on controlling or easing inflammation. […] Yes, it can, depending on the cause. For example, if nasal polyps cause chronic sinusitis, removing the polyps could cure the condition. […] If youve had sinusitis symptoms for weeks, its time to contact a healthcare provider. Sinusitis symptoms include thick green or yellow mucus from your nose, or it hurts when you put gentle pressure on your nose, forehead or around your eyes. […] Chronic sinusitis is different from recurrent sinusitis because chronic sinusitis symptoms dont go away for long periods of time. In recurrent sinusitis, you have four or more bouts of sinusitis in one year, but you also have symptom-free periods in between.
  • #66 Sinusitis (sinus infection)
    https://www.nhs.uk/conditions/sinusitis-sinus-infection/
    Sinusitis is swelling of the sinuses, usually caused by an infection. The main symptoms of sinusitis include: pain, swelling and tenderness around your cheeks, eyes or forehead; a blocked or runny nose; a reduced sense of smell; green or yellow mucus from your nose; a high temperature. Other symptoms include: a headache; toothache; bad breath; a cough; a feeling of pressure in the ears. Sinusitis causes the lining of the sinuses to swell up. This stops mucus draining into your nose and throat properly, making you feel blocked up. If a GP thinks your sinusitis needs treatment, they may prescribe medicines such as: steroid nasal sprays or drops to reduce the swelling in your sinuses you might need to take these for a few months; antihistamines if an allergy is causing your symptoms. Rarely, you may need antibiotics. This is not common as sinusitis is usually caused by a virus, not bacteria. The GP may refer you to an ear, nose and throat (ENT) specialist if you: still have sinusitis after 3 months of treatment; keep getting sinusitis; only have symptoms on 1 side of your face. Surgery to treat chronic sinusitis is called functional endoscopic sinus surgery (FESS). FESS is carried out under general anaesthetic (where you’re asleep). The surgeon can widen your sinuses by either: removing some of the blocked tissue; inflating a tiny balloon in the blocked sinuses, then removing it.
  • #67
    https://newsroom.uw.edu/news-releases/chronic-sinus-inflammation-appears-alter-brain-activity
    Chronic rhinosinusitis affects about 11% of U.S. adults, according to the Centers for Disease Control and Prevention. The condition can necessitate treatment over a span of years, typically involving antibiotics. Repeated cycles of inflammation and repair thicken sinus tissues, much like calloused skin. Surgery may resolve the issue, but symptoms also can recur. […] The participants with moderate and severe sinus inflammation were young individuals who did not show clinically significant signs of cognitive impairment. However, their brain scans told us a different story: The subjective feelings of attention decline, difficulties to focus or sleep disturbances that a person with sinus inflammation experiences might be associated with subtle changes in how brain regions controlling these functions communicate with one another, said Simonyan.
  • #68
    https://newsroom.uw.edu/news-releases/chronic-sinus-inflammation-appears-alter-brain-activity
    Chronic rhinosinusitis affects about 11% of U.S. adults, according to the Centers for Disease Control and Prevention. The condition can necessitate treatment over a span of years, typically involving antibiotics. Repeated cycles of inflammation and repair thicken sinus tissues, much like calloused skin. Surgery may resolve the issue, but symptoms also can recur. […] The participants with moderate and severe sinus inflammation were young individuals who did not show clinically significant signs of cognitive impairment. However, their brain scans told us a different story: The subjective feelings of attention decline, difficulties to focus or sleep disturbances that a person with sinus inflammation experiences might be associated with subtle changes in how brain regions controlling these functions communicate with one another, said Simonyan.
  • #69
    https://newsroom.uw.edu/news-releases/chronic-sinus-inflammation-appears-alter-brain-activity
    It is plausible, she added, that these changes may cause more clinically meaningful symptoms if chronic sinusitis is left untreated. It is also possible that we might have detected the early markers of a cognitive decline where sinus inflammation acts as a predisposing trigger or predictive factor, Simonyan said.