Chronic nasal congestion can often be caused by chronic sinusitis which is a narrowing of spaces inside your nose and sinuses due to swelling and inflammation. The inflammation may result from infections, autoimmune disorders, or allergies. The condition persists for three months or longer despite receiving treatment.
Chronic sinusitis disrupts your ability to drain mucus, leaving your nose feeling stuffy. You'll have difficulties breathing through the nose, and the area around your eyes might feel tender or swollen.
Also known as chronic rhinosinusitis, this condition affects both children and adults. The condition is often caused by an infection, swollen linings of the sinuses, or growths in the sinuses (i.e. nasal polyps).
Symptoms of Chronic Sinusitis
Common signs and symptoms of chronic sinusitis include:
Thick, green, or yellow nasal discharge
Difficulties breathing through the nose due to congestion or obstruction
Lowered sense of taste and smell
Pain, swelling, and tenderness around the eyes, nose, cheeks, and forehead
Sometimes chronic sinusitis is accompanied by other symptoms such as earache, coughs, sore throat, aching upper jaws, bad breath, and fatigue.
Chronic sinusitis is often confused with acute sinusitis due to a large overlap in signs and symptoms. However, acute sinusitis is a short-term sinus infection and is often associated with colds or the flu, and it may include a fever.
The major distinction between the two conditions is that signs and symptoms associated with chronic sinusitis last for at least 12 weeks. You may suffer several bouts of acute sinusitis before developing chronic sinusitis.
Causes of Chronic Sinusitis
Chronic allergic or irritant inflammation: This is an inflammation of the lining of the nose and sinuses due to chronic irritation from environmental allergies (i.e. pollen, dust mites, animal dander, etc.) or irritants in the air (i.e. pollution, smog, smoke, fumes, cleaning solutions etc.).
Nasal polyps: These are tissue growths inside the nose that block the sinuses or the nasal passage.
Deviated septum: A malformed wall between the nostrils may block or restrict sinus passage and worsen the symptoms.
Respiratory tract infections: Colds and other viral, fungal, and bacterial infections inflame and thicken the sinus membranes. The resulting blockage interferes with the mucus drainage.
Compromised immune system: Complications of immune system conditions such as HIV and cystic fibrosis can lead to nasal blockage.
Chronic Nasal Congestion Treatment Options
You should consult an expert ear, nose, and throat (ENT) specialist if your symptoms linger for more than three months, or if they keep returning after treatment. The specialist will request a CT scan of your sinuses and nose alongside examining your nasal cavity with an endoscope. The doctor may also need blood and allergy tests and bacterial culture.
Decongestants and nasal irrigation keep the mucus loose and clear the nasal passage; hence may be helpful in the treatment of chronic sinusitis. Mucus thinning agents and nasal steroids can also be helpful. However, your doctor may recommend surgery if the sinus problem is anatomical. Anatomical problems include a deviated septum, nasal polyps, narrowed nasal, and sinus passages due to prolonged infection or chronic inflammation.
Minimally invasive surgery helps to reduce the frequency and severity of sinus infections. In most cases, surgery restores normal sinus function. In-office Balloon Sinuplasty and Functional Endoscopic Sinus Surgery (FESS) are the most effective treatment options for chronic sinus congestion. They're both minimally invasive outpatient procedures.
In-office Balloon Sinuplasty
Balloon sinuplasty is an in-office procedure that offers almost instantaneous relief from sinus-related pains. Surgeons use this procedure to expand the sinus pathways to restore proper drainage capabilities. This procedure works by remodeling the anatomy of the nasal and sinus passages.
During in-office balloon sinuplasty, the surgeon places tiny balloons in the nose and sinuses. The balloons are then inflated to expand the sinus pathways permanently then removed immediately. Since the procedure is relatively fast and straightforward, it doesn't require general anesthesia. Instead, it is done using local or topical anesthesia.
One of the perks of balloon sinuplasty is that it provides instant relief and has minimal recovery time. Enlarging the sinus pathways reduces the chances of an infection recurring.
Usually, patients are baffled by this treatment's simplicity and efficiency. There's no nasal packing, and you can often return to work the following day free from sinus-related pains. Consider this surgical solution if you suffer at least four sinus infections per year and the regular medication doesn't resolve sinus pain and infection.
An in-office balloon sinuplasty is often carried out in conjunction with in-office turbinate reduction. That helps prevents sinus headaches and recurrent sinus infections. It also addresses the daily issues with nasal obstruction or congestion and dense postnasal drip.
Functional Endoscopic Sinus Surgery (FESS)
Functional endoscopic sinus surgery is also a minimally invasive sinus surgery that treats advanced chronic sinus infections. It's the ideal way to address sinus infections that aren't treatable by In-office Balloon Sinuplasty.
Ideal candidates for this surgical procedure have severely deviated septums, nasal polyps, large turbinates, thick infected secretions, and fungal sinus disease, among other severe sinus issues.
The minimally invasive procedure takes 45 minutes to 2 hours, depending on the severity of the chronic sinus infection. It uses innovative image guidance technology and doesn't use any external incisions on the patient's face. Image-guidance technology entails uploading a preoperative CT scan of your sinuses to a special computer during surgery.
The technology allows the surgeon to target the diseased areas within the nose and sinuses with great precision. The procedure doesn't disturb the healthy tissues, minimizing risk to the adjacent structure such as the eyes and brain.
The FESS procedure uses general anesthesia, but patients can go home with an hour or two of undergoing surgery. After that, you'll need a recovery period of 3 to 5 days before you can resume work.
Surgeons often combine the FESS procedure with nasal valve repair, deviated septum repair, polyp removal, turbinate reduction, and more. The additional procedures provide a permanent solution to the nose and sinus problems. In addition, they help the patient breathe properly through the nose.
It takes up to three weeks for the benefits of a FESS procedure to kick in. After that, patients feel better without nasal obstruction, postnasal discharge, sinus headache, and coughing. They also report improved sleep and sense of taste and smell.
Surgical intervention is an efficient treatment for chronic nasal congestion. The procedures are minimally invasive and require no hospitalization. Hence the procedures result in minimal disruption in the patient's life. In-office balloon sinuplasty provides lasting benefits but may not treat advanced or severe sinus infections.
Functional Endoscopic Sinus Surgery treats the more severe cases without making any incisions on the face. FESS is often paired with other procedures to treat the underlying causes and help the patient breathe properly.