Sinusitis

A cold usually improves within 7 to 10 days. If congestion, facial pressure, thick discharge, or reduced smell persists beyond this, keeps recurring, or worsens after initial improvement — particularly with a "double worsening" pattern where you feel better briefly then deteriorate again — specialist review is appropriate. That rebound pattern often signals a bacterial component on top of a viral illness.

The vast majority of sinus infections — around 90 to 98 percent — are viral and resolve without antibiotics, usually within 10 to 14 days. Bacterial sinusitis typically persists beyond 10 days without improving, or worsens after a period of initial improvement. Antibiotics are only appropriate when bacterial infection is suspected based on symptom duration and pattern, and are not needed for most sinus episodes.

Imaging is not required for most sinus episodes. A CT scan of the sinuses is considered when symptoms are persistent or recurrent, one-sided, not responding to appropriate treatment, or when surgical planning is needed. Routine X-rays add little in sinusitis and are generally not useful. CT without contrast is the gold standard when imaging is clinically indicated.

No. Many patients improve with a structured medical programme — nasal saline irrigation, intranasal corticosteroid sprays, and addressing any underlying allergy or anatomical factors. Surgery is discussed only when symptoms remain significant despite appropriate conservative management over time.

Use a pre-mixed sterile saline sachet dissolved in cooled boiled water — not tap water. Stand over a sink, tilt your head sideways, and gently pour or squeeze the solution into the upper nostril, allowing it to drain from the lower nostril. Breathe through your mouth throughout. Rinse both sides. Clean your rinse device thoroughly after each use and allow it to air dry. Common products available in Australian pharmacies include NeilMed Sinus Rinse and Flo Sinus Care. Your surgeon can advise on volume and frequency for your specific situation.

Intranasal corticosteroid sprays are the mainstay of medical treatment for chronic and recurrent sinusitis. Available Australian options include mometasone furoate (Nasonex), budesonide (Rhinocort), and fluticasone furoate (Avamys). These reduce inflammation in the nasal lining and improve sinus drainage. They require consistent daily use — maximum benefit typically develops over one to two weeks. They are safe for long-term use and are available at Australian pharmacies, some without prescription. Your surgeon will advise on the most appropriate option and technique for your situation.

Yes, and the combination is more effective than either alone. The recommended sequence is to rinse first with saline to clear mucus and debris, then apply the corticosteroid spray to clean mucosa where it can work more effectively. This approach is a standard component of a structured sinus care plan.

Yes. Persistent nasal blockage, facial pressure, and post-nasal drip can significantly disrupt sleep quality and daytime focus. Research comparing chronic sinusitis with other long-term conditions has found that patients report similar impairment of energy, work performance, and mental health. Improving sinonasal control often produces meaningful improvement in day-to-day function.

Different sinuses produce different pain patterns. The frontal sinuses — behind the forehead — tend to cause forehead pain that worsens when lying on your back. The ethmoid sinuses — between the eyes — cause pain between or behind the eyes, and sometimes eyelid swelling. The maxillary sinuses — behind the cheeks — produce pain across the cheeks and upper teeth, which is sometimes mistaken for a dental problem. The sphenoid sinuses, deep behind the nose, can cause a diffuse deep headache. In practice, symptoms often overlap and are not always predictable.

Sinusitis very rarely causes serious complications, but they do occur. Go to an emergency department promptly if you develop: swelling or redness around one or both eyes; vision changes, double vision, or loss of vision; severe headache that is different from your usual headaches; a stiff neck; significant facial swelling; or high fever with confusion or drowsiness. These are potential signs of spread to the eye socket or brain and require immediate assessment.

Yes. Saline nasal irrigation is the single most evidence-supported self-care measure and can be started straight away using products from any Australian pharmacy. Stay well hydrated — this helps thin mucus and supports drainage. Inhaling steam in a hot shower may temporarily ease congestion. Paracetamol or ibuprofen can help with facial pain and pressure. Sleeping with your head slightly elevated may reduce overnight congestion. Avoid decongestant nasal sprays containing oxymetazoline (such as Dimetapp or Sudafed nasal spray) for more than three to five days — prolonged use causes rebound congestion.

Individual surgeons within My-ENT may approach assessment and management differently based on their subspecialty training and clinical experience. Your surgeon will discuss the most appropriate pathway for your specific situation at your consultation.