Struggling with ongoing sinusitis? causes and long-term relief (2025)

Sinusitis is a common condition that causes persistent nasal congestion, facial pain, and breathing difficulties. While many cases resolve with medication, many people suffer from long-standing sinusitis (lasting more than 12 weeks). We spoke with Dr Vikas Acharya to explore when endoscopic sinus surgery may be required for long-term relief.

Why does sinusitis keep coming back?

While acute sinusitis usually resolves with medication, there are many reasons why sinusitis can recur.

Underlying allergies

Persistent nasal inflammation can be caused by allergic rhinitis (hay fever), which makes the sinuses more prone to infections. Common triggers include dust, pollen, pet dander, and mould.

Structural issues in the nose

Proper airflow and drainage may be obstructed by a deviated septum, nasal polyps, or narrow sinus passages, leading to frequent infections.

Chronic inflammation

Conditions such as asthma or chronic rhinosinusitis with nasal polyps cause ongoing inflammation in the nasal passages, making sinus infections more likely to return.

Weak immune system

A weakened immune system can make it harder to fight off infections, increasing the risk of repeated sinusitis.

Dental-related sinus infections

Odontogenic sinusitis, or dental-induced sinusitis occurs when an infection from the upper teeth spreads to the maxillary sinuses, leading to recurrent sinusitis. This may be caused by untreated dental infections, tooth extractions, dental implants, or root canal complications.

Symptoms of chronic sinusitis

Sinusitis occurs when the sinuses become inflamed. Common symptoms include:

• Persistent nasal congestion and difficulty breathing.
• Facial pain or pressure around the eyes, forehead, or cheeks.
• Postnasal drip, leading to throat irritation.
• Headaches.
• Reduced sense of smell and taste.
• Bad breath (halitosis), caused by mucus buildup and bacterial growth.

How does endoscopic sinus surgery help?

If you have chronic sinusitis (lasting more than 12 weeks) or frequent sinus infections, you may need more than just medication.

Endoscopic sinus surgery (FESS) is a minimally invasive procedure that helps unblock the sinuses and restore normal drainage inserting an endoscope (a thin, flexible camera) through the nostrils.

The procedure takes between 60 to 90 minutes and is usually performed under general or local anaesthesia.

Benefits of endoscopic sinus surgery:

• Minimally invasive: the procedure is performed without external incisions, reducing scarring and pain.
• Fast recovery: most patients resume normal activities within one to two weeks.
• Improved breathing: widening the sinus passages enhances airflow.
• Long-term relief: reduces the frequency and severity of infections.

How is the recovery after surgery?

Most patients go home the same day experiencing mild discomfort, congestion, and nasal discharge. Avoid blowing your nose forcefully, exposure to smoke, and heavy exertion to prevent complications.

Recovery timeline:

Some bleeding and congestion are common in the first few days. Pain relief and saline rinses help manage discomfort.

Swelling gradually reduces during the first couple of weeks 1-2 weeks. Avoid heavy lifting and strenuous activity.

Full recovery is expected after 6 weeks, with better sinus function and long-term relief

Risks and complications

Endoscopic sinus surgery is highly safe, but as with any procedure, some risks exist.

• Mild bleeding: this is common in the first few days and typically resolves on its own.
• Temporary nasal congestion: the nose may feel blocked due to swelling but it gradually improves.
• Infection:although it is rare, an infection may require antibiotics if it occurs.
• Scar tissue formation: scar tissue may develop inside the nasal passages requiring a follow-up treatment.
• Changes in smell:uncommon but possible if nerves are affected.

Your ENT specialist will discuss these risks in detail before the procedure.

Will surgery permanently cure sinusitis?

For most patients, endoscopic sinus surgery provides long-term relief, improving breathing, sleep quality, and quality of life.

Whilst endoscopic sinus surgery significantly reduces sinusitis symptoms, it does not guarantee permanent relief, especially for those with allergies or chronicinflammatory conditions.

Chronic sinusitis can be debilitating, but modern treatments like endoscopic sinus surgery can provide lasting relief for those with structural issues or chronic inflammation.

If you experience persistent congestion, facial pain, or recurrent infections, visit Dr Vikas Acharya's profileto discover the best treatment options for you.