Chronic Sinusitis Treatment in Sydney

Chronic sinusitis is persistent inflammation of the sinuses lasting 12 weeks or longer, causing nasal blockage, facial pressure, reduced sense of smell and thick nasal discharge. It affects approximately one in ten Australians and can significantly reduce quality of life when left untreated.

Symptoms of Chronic Sinusitis

The hallmark of chronic sinusitis is symptoms that persist beyond 12 weeks despite initial treatment. Patients commonly experience a combination of:

Persistent nasal congestion or obstruction on one or both sides
Thick, discoloured nasal discharge or post-nasal drip
Facial pain, pressure or fullness, especially around the cheeks, forehead and eyes
Reduced or lost sense of smell (hyposmia or anosmia)
Headache, particularly on bending forward
Fatigue and general malaise
Ear pressure or fullness
Bad breath (halitosis)

Symptoms may fluctuate in severity but do not fully resolve. If you have experienced these symptoms for three months or longer, specialist assessment is recommended.

Causes and Risk Factors

Chronic sinusitis is a multifactorial condition. Rather than a single cause, it usually results from a combination of factors that create ongoing inflammation in the sinus lining:

Nasal polyps: benign growths in the sinus lining that block drainage pathways
Allergic rhinitis: chronic allergic inflammation that swells the nasal mucosa
Deviated nasal septum: a crooked partition between the nostrils that restricts airflow and sinus drainage
Asthma and aspirin sensitivity: strongly associated with nasal polyps and recurrent sinusitis
Immune deficiency: conditions that impair the body's ability to fight infections
Recurrent acute infections: repeated bacterial infections that damage sinus tissue over time
Environmental irritants: cigarette smoke, pollution and occupational dust exposure

Diagnosis

At Central Sydney ENT, our specialists take a thorough approach to diagnosing chronic sinusitis. A typical assessment includes:

Clinical history and examination: Your ENT surgeon will review your symptom history, previous treatments, allergy status and any relevant medical conditions. A nasal examination using a rigid or flexible endoscope allows direct visualisation of the nasal passages and sinus openings.

CT scan of the sinuses: A non-contrast CT scan is the gold standard for assessing the extent of sinus disease, identifying polyps, and evaluating the anatomy of the sinuses prior to any surgical planning.

Allergy testing: Skin prick testing may be recommended to identify specific allergic triggers contributing to your sinusitis. Our practice offers on-site allergy screening.

Treatment Options

Treatment for chronic sinusitis typically begins with medical therapy and progresses to surgery when conservative measures are insufficient.

Medical Management

Saline nasal irrigation: regular rinsing with saline solution to clear mucus and reduce inflammation
Intranasal corticosteroid sprays: daily use to reduce mucosal swelling and polyp size
Short courses of oral corticosteroids: for acute flare-ups or significant polyp burden
Antibiotics: targeted courses when bacterial infection is confirmed or suspected
Allergy management: antihistamines, allergen avoidance and potentially immunotherapy

Endoscopic Sinus Surgery (ESS)

When medical therapy fails to adequately control symptoms, endoscopic sinus surgery is the standard surgical treatment. The procedure is performed entirely through the nostrils using a thin telescope and specialised instruments, with no external incisions or visible scarring.

The goals of surgery are to open blocked sinus drainage pathways, remove diseased tissue and polyps, and create a sinus cavity that can be easily maintained with ongoing medical therapy. Surgery is performed under general anaesthesia as a day procedure or with a single overnight stay.

Our rhinology-trained surgeons: including Dr Rahuram Sivasubramaniam, Dr Alexander Zhang, Dr Jareen Ebenezer and Dr Arjuna Ananda: perform endoscopic sinus surgery using the latest image-guided navigation technology for precision and safety.

Biologic Therapy

For patients with severe chronic sinusitis with nasal polyps (CRSwNP), particularly those with concurrent asthma, biologic medications such as dupilumab may be recommended. These targeted therapies work by blocking specific inflammatory pathways and can dramatically reduce polyp burden and improve symptoms.

When to See an ENT Specialist

You should seek a referral to an ENT specialist if:

Your sinus symptoms have persisted for 12 weeks or longer
Multiple courses of antibiotics have not resolved your symptoms
You have been diagnosed with nasal polyps
You have lost your sense of smell
You experience recurrent acute sinus infections (four or more per year)
You develop warning signs such as eye swelling, visual changes, or severe headache

Related Conditions

Chronic sinusitis is closely linked to several other conditions treated at Central Sydney ENT:

Nasal Polyps: found in up to 40% of chronic sinusitis patients
Deviated Septum: can obstruct sinus drainage and worsen sinusitis
Allergic Rhinitis: a major contributing factor to chronic sinus inflammation

Common Questions

Chronic Sinusitis FAQ

What is the difference between acute and chronic sinusitis? +

Acute sinusitis lasts less than 4 weeks and is usually caused by a viral or bacterial infection. Chronic sinusitis persists for 12 weeks or longer despite treatment, and is often driven by inflammation, nasal polyps, allergies or anatomical factors rather than infection alone.

When should I see an ENT specialist for sinusitis? +

You should see an ENT specialist if your sinus symptoms have persisted for more than 12 weeks, if you have had multiple courses of antibiotics without improvement, if you develop nasal polyps, or if you experience complications such as eye swelling, severe headache or visual changes.

Is sinus surgery painful? +

Endoscopic sinus surgery is performed under general anaesthesia, so you will not feel pain during the procedure. Post-operative discomfort is typically mild to moderate, managed with simple pain relief, and most patients return to normal activities within one to two weeks.

Can chronic sinusitis come back after surgery? +

Sinus surgery significantly improves symptoms in the majority of patients, but chronic sinusitis can recur, especially in patients with nasal polyps, allergies, or asthma. Ongoing medical therapy including nasal rinses and steroid sprays helps maintain long-term results.

Does Central Sydney ENT treat chronic sinusitis? +

Yes. Central Sydney ENT has six FRACS-qualified ENT surgeons with subspecialty training in rhinology and sinus surgery. We offer comprehensive diagnosis, medical management, and endoscopic sinus surgery across seven Sydney locations including Burwood, Campbelltown, Gregory Hills, Ultimo, Drummoyne, Hunters Hill and Miranda.