sinus infection procedure preparation

Overview

A sinus infection (also called sinusitis) is swelling or inflammation of the lining of your sinuses — the air-filled spaces inside your face. If the infection does not clear up with treatment, your doctor may recommend a procedure to open the sinuses, allowing them to drain properly.

Sinus infections are very common, but needing a procedure for them is less common. Only a small number of people with chronic sinus infections will need surgery.

Sinus infections can affect people of all ages, but a sinus procedure is more often recommended for adults who have chronic (long-lasting) sinusitis that has not improved with other treatments.

Symptoms

Common symptoms

• Pain, pressure, or fullness in the face, forehead, or around the eyes
• A stuffy or blocked nose that makes it hard to breathe through the nose
• Thick, discoloured mucus from the nose or down the back of the throat
• Reduced sense of smell
• Headache or pain in the teeth

Symptoms in children

• Nasal congestion that lasts more than a week
• Irritability or fussiness
• A cough that gets worse at night
• Swelling around the eyes
• Low energy or tiredness

Symptoms in older adults

• Confusion or drowsiness, which can be a sign of a more serious infection
• Fever that may be lower than in younger people
• A cough that lingers for weeks
• Fatigue and a general feeling of being unwell
• Changes in sense of smell that affect appetite

Causes

Main causes

• Viral infections, like the common cold, which can cause the sinus lining to swell and block mucus drainage
• Bacterial infections, which can develop when mucus stays trapped in the sinuses
• Nasal polyps — small non-cancerous growths in the nose
• Deviated septum — when the wall between the nostrils is not straight
• Allergies, which can cause chronic inflammation of the nasal lining

Risk factors

• A previous cold or upper respiratory infection
• Allergic rhinitis (hay fever) or asthma
• A weak immune system due to other health conditions
• Smoking or exposure to second-hand smoke
• Structural problems in the nasal passage, such as a deviated septum
• Certain medical conditions that affect the movement of mucus in the airways

When to see a doctor

See a doctor urgently if:

• You have swelling around your eyes, or a very severe headache
• You have a stiff neck and a fever
• Your symptoms are getting worse after you seemed to recover
• You have sinus symptoms that have lasted more than 12 weeks

Book a routine appointment if:

• You have sinus symptoms that do not get better after 7 to 10 days
• You are getting frequent sinus infections that keep coming back
• You have nosebleeds or a reduced sense of smell that does not go away

Diagnosis

To find out if you have a sinus infection that may need a procedure, your doctor will ask about your symptoms and look inside your nose with a small light. They may also use a thin, flexible tube with a camera, called an endoscope, to see your sinuses more clearly.

Tests that may be done

• Nasal endoscopy — a thin tube with a small camera is gently passed into your nose
• A CT scan — a special X-ray that provides detailed images of your sinuses
• A nasal swab — a cotton-tipped swab is used to collect a sample of mucus to check for bacteria or fungi
• An allergy test, if allergies are suspected

What to expect at your appointment

Your doctor will discuss the results with you, including whether a procedure might help. If you need a procedure, they will give you referral to a specialist who will plan your care and explain exactly what will happen.

Treatment

Treatment for sinus infections often begins with home care and medicines. If these do not help, or if the problem is long-lasting, a sinus procedure may be recommended. The type of procedure depends on the cause and exactly where the blockage is. Before the procedure, your specialist will give you clear instructions on how to prepare, including any medicines to pause and when to stop eating and drinking.

Self-care at home

• Use saline (salt-water) sprays or rinses to keep your nasal passages moist and clear mucus
• Breathe in steam from a warm shower or a bowl of hot water to help open your sinuses
• Place a warm, moist cloth over your face to ease pain and pressure
• Drink plenty of fluids to keep the mucus thin
• Get plenty of rest to help your body recover

Medical treatments

Your doctor may prescribe a nasal steroid spray to reduce inflammation, or a short course of antibiotics if a bacterial infection is confirmed. They may also recommend a decongestant for short-term relief. Always take any prescribed medicine exactly as instructed.

When is surgery considered?

Surgery is considered when sinusitis does not get better with other treatments, or when there are blockages that make it hard for sinuses to drain. The most common procedure is functional endoscopic sinus surgery (FESS), where a surgeon uses a thin telescopic camera to open blocked sinuses. This is done through the nostrils, so there are no cuts on the face. Preparation includes stopping certain medicines and fasting before the procedure, but your specialist will give you clear instructions.

Living with this condition

After a sinus procedure, your nose may be blocked for a few days, and you may have some bloody discharge. Your doctor will tell you how to care for your nose at home, including when to rinse with salt water and how to position your head to help healing.

Lifestyle tips

• Avoid blowing your nose for the first few days after the procedure
• Do not lift heavy objects or exercise strenuously until your doctor says it is safe
• Keep your head raised, even when sleeping, to reduce swelling
• Do not smoke, and avoid smoky places
• Follow all nasal rinse instructions from your care team

Diet and exercise

Eating a healthy, balanced diet and drinking plenty of water can support your recovery. After a sinus procedure, start with soft, easy-to-chew foods if your throat is sore from the anaesthetic. When your doctor clears you to exercise, begin gradually and avoid activities that involve straining.

Mental health and emotional wellbeing

Living with chronic sinusitis can be tiring and frustrating. The symptoms can affect your sleep, concentration, and mood. It is normal to feel anxious about a procedure. If you feel low or worried, talk to your doctor or a counsellor. You do not have to manage it alone.

Prevention

Not all sinus infections can be prevented, but you can lower your chances by managing allergies, avoiding upper respiratory infections, and keeping your nasal passages clear with saline rinses. If you smoke, stopping smoking can make a big difference.

Vaccines

Some infections that lead to sinusitis, such as influenza (flu) and COVID-19, can be prevented with vaccines. Ask your pharmacist or GP which vaccinations are recommended for you.

Screening programmes

There is no routine screening for sinus infections, but if you have frequent or long-lasting symptoms, a specialist can assess whether there are underlying causes, like allergies or polyps.

Complications

If left untreated

• An infection that spreads beyond the sinuses to the area around the eye, which can threaten vision
• Inflammation of the membranes around the brain (meningitis)
• Loss of sense of smell that may be permanent in rare cases
• Bone infection (osteomyelitis) in very severe cases
• Worsening of asthma symptoms

Long-term outlook

With the right treatment, the vast majority of people with sinusitis get better. If you need a sinus procedure, it is important to remember that while recovery takes time, it often leads to a significant reduction in symptoms. Many people say their breathing improves and they get fewer sinus infections. Your care team will support you every step of the way.

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