Understanding Sinusitis — Causes, Treatment, and When Surgery Is Needed

Dr. G. V. Nagarjuna Reddy

MS (PGI)

ENT Surgeon
Attapur

Sinusitis is one of the most common ENT problems seen in Hyderabad — yet often ignored until it becomes chronic.
In simple terms, sinusitis means inflammation of the air-filled cavities (sinuses) around the nose and eyes.
These sinuses normally produce mucus that drains through small openings into the nose. When blocked, infection develops.

Sinus Cavities and Nasal Pathways — Common Site of Infection

Types of Sinusitis

Acute Sinusitis:
Short-term infection (usually after a cold or flu) lasting less than 4 weeks. Symptoms include blocked nose, headache, facial pain, and nasal discharge.
Chronic Sinusitis:
Long-standing infection or inflammation lasting more than 12 weeks, often due to allergies, nasal polyps, or deviated septum.

A story from my practice

A 35-year-old teacher came to my practice complaining of persistent nasal blockage, heaviness in the head, and postnasal drip for several months.
She had been using nasal drops frequently for temporary relief.
A nasal endoscopy and CT scan showed chronic sinusitis with deviated nasal septum.

After a short course of medical therapy, she underwent a Functional Endoscopic Sinus Surgery (FESS) — a modern, scarless technique to open blocked sinuses.
Within weeks, her symptoms resolved completely, and she could breathe freely again.

Medical Treatment

For most patients, sinusitis can be managed without surgery.
Treatment includes:

Steam inhalation and saline nasal washes to clear mucus
Antibiotics for bacterial infection
Nasal steroid sprays to reduce swelling
Antihistamines if allergy is the cause
Avoiding self-use of decongestant drops (can cause rebound blockage)

Surgical Treatment Options

When medical therapy fails, or if there are structural problems, surgery may be needed.

🔹 Functional Endoscopic Sinus Surgery (FESS)

Performed using a nasal endoscope without external cuts.
Opens blocked sinus openings, clears infection, and improves drainage.
Day-care procedure; recovery within a few days.

🔹 Septoplasty

Corrects a deviated nasal septum that contributes to blockage.
Often combined with FESS for long-term relief.

💰 Fees: Surgical cost depends on hospital setup and extent of surgery.
Typically ranges between ₹25,000 – ₹60,000, including anesthesia and follow-up.

Complications of Chronic Sinusitis

If untreated, chronic sinusitis can cause:

Persistent headaches and facial pain
Loss of smell
Recurrent throat and ear infections
Orbital or eye infection (rare)
Spread of infection to brain (extremely rare but serious)

The Ear–Nose–Throat Connection Explained

The ear, nose, and throat are all connected through air passages.
When sinus infection spreads:

Postnasal drip irritates the throat, causing cough or sore throat.
Blocked sinuses affect ear pressure, leading to ear fullness or hearing issues.
Chronic inflammation can impact voice, breathing, and sleep quality.

That’s why ENT specialists treat the entire system, not just one organ.

Final Thoughts

Sinusitis may seem minor at first, but chronic inflammation can significantly affect your quality of life.
With timely diagnosis, proper medical care, and modern endoscopic surgery, long-term relief is possible.

Don’t ignore persistent nasal blockage or facial pain — your sinuses might be asking for help.