- Content version
- 1.0
- Last scientific review
- مايو 2026
Acute and chronic: symptoms and treatment
What are the sinuses?
The sinuses are air-filled cavities within the facial bones that connect to the nose through small openings. When the lining of the nose and sinuses becomes inflamed and these openings become blocked, secretions build up and sinusitis develops.
Most acute cases are caused by a virus and resolve on their own.
What's the difference between acute and chronic?
Acute sinusitis: often begins after a cold and lasts less than 4 weeks.
Chronic sinusitis: symptoms persist for 12 weeks or more despite treatment, sometimes accompanied by nasal polyps.
What are the common symptoms?
- Nasal congestion
- Nasal discharge or postnasal drip
- Facial pain or pressure, or pressure around the eyes
- Reduced or lost sense of smell
- Headache, cough, or fatigue
Fever may appear with acute sinusitis, while chronic sinusitis tends to cause milder but long-lasting symptoms.
Not every forehead headache is sinusitis. A headache without congestion, discharge, or reduced smell usually has another cause.
What are the causes and risk factors?
- Colds and viral infections — the most common cause of acute sinusitis
- Allergic rhinitis
- Nasal polyps
- Smoking and smoke exposure
- Asthma
- Occasionally, infection in the roots of the upper teeth
How is it diagnosed?
Acute sinusitis is usually diagnosed from symptoms and examination and does not typically need imaging. Chronic sinusitis requires nasal endoscopy, and the doctor may request a sinus CT scan, especially when surgery is being considered.
How is acute sinusitis treated?
- Rest and adequate fluids
- Saline nasal rinses
- Pain relievers and fever reducers as needed
- A nasal steroid spray in some cases
Antibiotics aren't always necessary
Most acute cases are viral, and antibiotics don't help. Your doctor decides whether one is needed when symptoms suggest a bacterial infection. If prescribed, complete the full course.
How is chronic sinusitis treated?
It requires regular, long-term treatment, with saline nasal rinses and a nasal steroid spray as the cornerstone. Some patients need additional treatments determined by their doctor. When there's no improvement despite treatment, endoscopic sinus surgery may be recommended, or biologic therapies for some patients with nasal polyps.
What can I do at home?
- Rinse your nose with saline, using boiled-then-cooled or sterile water.
- Drink enough fluids.
- Inhale warm steam cautiously, keeping children away from hot water.
- Elevate your head slightly during sleep.
- Avoid smoking, smoke, and incense.
- Don't use decongestant sprays for more than 3 days.
When should I see a doctor?
- If symptoms last more than 10 days without improvement.
- If they improve and then worsen again.
- If symptoms are severe with high fever.
- If sinusitis recurs several times a year.
- If symptoms last more than 12 weeks.
Go to the emergency room immediately if you notice:
- Swelling or redness around the eye
- Double vision or weakened vision
- Severe headache with neck stiffness
- Forehead swelling
- Confusion or unusual drowsiness
Remember
- Most acute cases improve within one to two weeks without antibiotics.
- Saline rinses and steroid sprays are the foundation of chronic sinusitis treatment.
- Sticking with treatment matters more than constantly changing it.
- Eye swelling or vision changes are a medical emergency.
This information is for health awareness and education, and does not replace a doctor's consultation or direct medical assessment.
Prepared by: Saudi Society of Otolaryngology–Head & Neck Surgery · Version 1.0 · Last reviewed: May 2026 · saudiorl.com
