Chronic sinusitis is a persistent inflammation of the sinuses, lasting 12 weeks or longer, despite treatment, often leading to facial pain, congestion, and reduced sense of smell.
Ranked by community outcomes, then evidence grade, Health Voice mentions, and recency.
Why it may help Chronic Sinusitis: Often low in chronic sinusitis
Why it may help Chronic Sinusitis: Supports mucosal immunity
Why it may help Chronic Sinusitis: Zinc supports immune function and has anti-inflammatory properties, which may help reduce the duration and severity of infections contributing to chronic sinusitis.
A pungent root that has been studied for nausea and digestive comfort.
Why it may help Chronic Sinusitis: Vitamin D modulates immune responses and reduces inflammation, which may help alleviate chronic sinusitis symptoms by improving mucosal immunity and reducing inflammatory processes in the sinuses.
Bromelain is a group of protein-digesting enzymes from pineapple, often used as a dietary supplement for its potential anti-inflammatory and tissue-healing properties.
N-Acetyl Cysteine (NAC) is a glutathione precursor with antioxidant, anti-inflammatory, and mucolytic properties, investigated for its potential therapeutic roles in a range of health conditions.
Suspended silver particles historically used for antimicrobial purposes.
Why it may help Chronic Sinusitis: Antimicrobial topical and oral
Why it may help Chronic Sinusitis: Reduces chronic inflammation
Why it may help Chronic Sinusitis: Antimicrobial for sinus pathogens
Why it may help Chronic Sinusitis: Reduces sinus inflammation
Why it may help Chronic Sinusitis: Modulates respiratory immune response
Why it may help Chronic Sinusitis: Reduces nasal inflammation
Why it may help Chronic Sinusitis: Omega-3 fatty acids, particularly EPA and DHA, exert anti-inflammatory effects by modulating prostaglandin synthesis, which may reduce inflammation and improve symptoms in chronic sinusitis.
Why it may help Chronic Sinusitis: N-Acetyl Cysteine acts as a mucolytic agent, breaking down disulfide bonds in mucus, which can reduce mucus viscosity and improve clearance in chronic sinusitis.
Magnesium is an essential mineral vital for numerous bodily functions, including energy production, muscle and nerve function, and bone health.
A flowering plant that has been studied for shortening common cold duration.
Sambucus nigra berry extract with strong evidence for shortening cold and flu duration.
Community outcomes
Self-reported by community members · not medical advice.
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Community Discussions
How global health authorities view Chronic Sinusitis.
The Mayo Clinic emphasizes nasal saline irrigation as a key self-care measure. The NCCIH acknowledges some traditional uses of herbs for respiratory conditions but notes that scientific evidence for most natural products in chronic sinusitis is limited. Conventional medical bodies generally focus on pharmaceutical interventions and surgical options for chronic sinusitis, with complementary approaches often viewed as supportive rather than primary treatments. The Cochrane Library has reviewed some interventions, finding varying levels of evidence for different approaches.
Indexed studies for Chronic Sinusitis, grouped by source type and quality.
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Pooled analyses across multiple human trials.
Association between diurnal temperature range and sinusitis: a multi-city time-series analysis.
Park MY, Lim YH, Lee DW, Oh JM, Myung J, Bae HJ · International journal of environmental health research · 2026
This study aimed to examine the association between diurnal temperature range (DTR) and the risk of sinusitis, a common upper respiratory tract infection, using the Korean National Health Information Database (NHID). We extracted data on hospital visits for acute and chronic sinusitis from the NHID spanning 16 administrative regions of South Korea from 2006 to 2019. The relationship between DTR and hospital visits was examined using a two-stage analytical approach that incorporated generalised additive models and meta-analysis. Furthermore, subgroup analyses were conducted using sex, age group, mean temperature percentiles, and PM10 concentration. We found associations between DTR and acute and chronic sinusitis with pooled relative risks of 1.0074 (95% confidence interval [CI]: 1.0060-1.0089) and 1.0082 (95% CI: 1.0064-1.0101) at a moving average lag day 4 (lag 0-4), respectively. Additionally, increased risks of DTR-related sinusitis were observed in individuals aged 15-65 yea
Wang H, Xu X, Lu Z, Zhai Z, Shao L, Song X · European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
Currently, there is a debate around the use of biological agents in the treatment of chronic sinusitis with nasal polyps. Therefore, this study's purpose was to assess the effectiveness of various biologics in the treatment of chronic rhinosinusitis with nasal polyps. A systematic and manual search was conducted for all relevant studies from inception to December 20, 2023. Two independent authors carried out the search, screening, assessment, and data extraction. Network meta-analysis was conducted using STATA 14 software. Our analysis includes a comprehensive set of 19 studies. These studies compared the efficacy of four distinct biologic treatments. The results of reticulated Meta-analysis showed that Dupilumab (MD = - 1.85, 95% CI: - 2.47, - 1.24), Omalizumab (MD = - 1.30, 95% CI: - 1.90, - 0.70), Benralizumab (MD = - 0.84, 95% CI: - 1.66, - 0.03) and Mepolizumab (MD = - 1.48,
Talugula S, Johnson V 2nd, Zhao L, Patel P, Lee V · The Journal of craniofacial surgery · 2024 · n=4213
Maxillary osteotomies as a component of orthognathic surgery disrupt the normal anatomy and function of the sinus. The osteotomy with advancement of the inferior component of the sinus leaves a bony and mucosal opening in the sinus. Immediately after surgery, nasal drainage is impeded because of intranasal swelling. Acute and chronic maxillary sinusitis would be expected; however, its incidence as an expected complication is not well documented. A systematic review and meta-analysis was completed using PubMed to determine the incidence of sinusitis after maxillary orthognathic surgery. Studies were reviewed by two authors, and incidence data were extracted. Two hundred six articles were identified with 24 meeting the criteria for analysis. The incidence of sinusitis was based on 4213 participants who had undergone orthognathic surgery. Twenty-three studies reported a total number of sinusitis cases, and the results demonstrated a pooled incidence of 3.3% (95% confidence interval: 1.77,
Structured reviews of the full body of evidence (incl. Cochrane).
Nimmagadda SV, Schmale IL, Man LX · American journal of rhinology & allergy · 2022 · n=10
Chronic rhinosinusitis (CRS) is a common condition that affects patients' quality of life. Standard treatments for CRS have known side effects and variable efficacy rates. Thus, complementary and integrative (CIM) treatments for CRS such as crenotherapy, which utilizes high mineral content water or vapor as an inhalation therapy, are of continued interest. To summarize and evaluate the current research investigating crenotherapy's therapeutic potential and clinical outcomes for the treatment of CRS. Systematic review and qualitative analysis. A systematic review was performed, with a comprehensive search strategy applied to 6 databases from inception to March 2021: CINAHL, Cochrane, Embase, PubMed, Scopus, and Web of Science. Studies with at least 10 patients, which investigated crenotherapy as the sole or adjunctive treatment for CRS in humans were included. In total, 10 articles out of 756 were included. Of these, 6 were randomized controlled trials. The remaining four articles w
Primary immunodeficiency and recalcitrant chronic sinusitis: a systematic review.
Mazza JM, Lin SY · International forum of allergy & rhinology · 2016
A subset of patients with chronic rhinosinusitis (CRS) has disease refractory to standard therapies. Primary immunodeficiency should be considered in this group. Past literature has demonstrated an association between immunodeficiency and chronic sinusitis. A systematic literature search was performed using OVID, MEDLINE, EMBASE, and Cochrane databases to identify English language papers containing original human data on subjects with primary immunodeficiency and chronic sinusitis. A total of 39 studies met inclusion criteria. Data was collected pertaining to immune dysfunction in patients with chronic sinusitis, the clinical workup for these patients, and the effectiveness of medical and surgical treatments. The studies were assessed to determine their level of evidence. The majority of studies were supported by Level 4 evidence. Up to 50% of patients with recalcitrant CRS were found to have immune dysfunction. The most frequent primary immunodeficiencies studied were common variabl
Quintanilla-Dieck L, Litvack JR, Mace JC, Smith TL · International forum of allergy & rhinology · 2012
Many disease-specific, quality-of-life (QOL) instruments exist for chronic rhinosinusitis (CRS), resulting in confusion about the best application and use of each instrument. We hypothesized that the most prevalently utilized instruments do not strongly correlate in all domains, but rather act in complementary fashion for QOL assessment. A systematic literature review (MEDLINE) was performed to identify the type and frequency of available CRS-specific QOL instruments. Univariate analyses of the 3 most common instruments (Rhinosinusitis Disability Index [RSDI], Chronic Sinusitis Survey [CSS] and 22-item Sinonasal Outcomes Test [SNOT-22]) were performed using a multi-institutional prospective cohort of sinusitis patients. Systematic literature review found that the SNOT-20 (and its derivatives), RSDI, and CSS are the most commonly utilized CRS-specific QOL instruments. The majority of RSDI domains were weakly or not correlated with the CSS domains (r = 0.097-0.501; p < 0.001). In co
Recommendations from medical societies (NICE, AHA, ADA, ACG, Endocrine Society…).
Sinusitis (acute): antimicrobial prescribing
NICE · Strength: Specific recommendations with supporting evidence levels
This guideline covers antimicrobial prescribing for acute sinusitis in adults and children. It aims to optimise antimicrobial use and reduce antimicrobial resistance.
Chronic rhinosinusitis: diagnosis and management
NICE
This guideline covers diagnosing and managing chronic rhinosinusitis (CRS) in adults and young people aged 12 years and over. It aims to improve care by providing recommendations on assessment, treatment options, and referral criteria.
Controlled human studies with random assignment.
Zhang Z, Tu J, Tang B, Xiong Y, Jia Y, Zhang M · The Laryngoscope · 2025
Few studies have compared the effectiveness of olfactory training (OT) and glucocorticoids (GC) in the phenotype of chronic sinusitis with nasal polyps (CRSwNP) with olfactory dysfunction (OD). To evaluate the effects of GC and OT on OD in patients with eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyps (NonECRSwNP). After 2 weeks of endoscopic sinus surgery, patients with a composite threshold discrimination identification score (TDIS) of less than 30.5 were randomly assigned to receive GC (n = 38), OT (n = 36), or both (n = 34). Retrospective phenotypic stratification of CRSwNP patients was performed based on whether eosinophils in the tissue exceeded 10% (ECRSwNP and NonECRSwNP). Follow-up assessments were conducted at 1, 3, and 6 months postintervention. Evaluations included TDIS, the 22-item Sino-Nasal outcome test (SNOT-22), Lund-Kennedy endoscopic s
Cervin A, Rimmer J, Wrobel A, Abelak Y, Brayton L, Kuang Y · International forum of allergy & rhinology · 2022
Topical steroids are first-line treatment for chronic rhinosinusitis (CRS), but fail to provide adequate symptom control for all patients. Designed for medical treatment failures, LYR-210 is an implantable matrix that locally elutes mometasone furoate to inflamed sinonasal tissue for up to 24 weeks in CRS patients. In an open-label phase 1 study, LYR-210 demonstrated clinically relevant improvement in the 22-item Sino-Nasal Outcome Test (SNOT-22). Safety and efficacy of LYR-210 in CRS were evaluated in the LANTERN Phase 2 study. Sixty-seven surgically naive adult CRS patients who were inadequately controlled by previous medical management and seeking an alternative treatment enrolled in a multicenter, blinded, controlled, dose-ranging study. Patients had moderate-to-severe disease based on SNOT-22 and composite 7-day average scores of the 4 cardinal CRS symptoms (4CS), with diagnosis confirmed by nasal endoscopy and magnetic resonance imaging. Patients were randomized (1:1:1) to salin
Onal M, Keles B, Erdur O, Alatas N, Onal O · Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2021
Flexible nasopharyngeal laryngoscopy (NPL) is a cost-effective, simple procedure that provides visualization of the nasal airways. However, it involves a number of challenges for both the clinician and the patient. Hypertonic saline nasal wash is used to prevent nasal secretion in acute/chronic sinusitis and after nasal surgery. We aimed to determine the efficacy of hypertonic saline by comparing the clinician's and patients' experiences during NPL. This prospective, double-blinded, randomized, controlled study was performed at a tertiary referral university hospital. Two hundred patients were randomly divided into hypertonic saline, lidocaine, xylometazoline, and isotonic saline groups. During NPL, the clinician's experiences in terms of the quality of the field of view and the patients' experiences in terms of pain and discomfort resulting from the 4 premedication drugs were compared. The groups differed significantly in terms of the clinician's field of view, and patients' pain sc
Cohort, case-control, and cross-sectional human studies.
Liu-Lam O, Hardin KM, Warren ZA, Edwards TS · The Medical clinics of North America · 2026
Rhinosinusitis is a significant contributor to patient morbidity, impacting quality of life and health care costs. This article provides an evidence-based review of rhinosinusitis, including classification, pathophysiology, diagnostic criteria, and management strategies. Special emphasis is placed on differentiating rhinosinusitis from other conditions, differences between acute and chronic sinusitis, the role of imaging, and indications for referral for potential surgical intervention.
Freeman A, Rink S, Bansal AT, Frankemölle B, Singh M, Sont JK · The Lancet regional health. Europe · 2026
The phenotypic nature of multimorbidity in severe asthma is poorly understood. Our aims in this study were to define multimorbidity phenotypes and their characteristics in severe asthma across Europe by identifying and characterising co-aggregation of comorbidities. Cross-sectional patient data were analysed from the pan-European Severe Heterogenous Asthma Research Collaboration: Patient Centred (SHARP) Central database of national severe asthma registries. Patients were grouped by four European regions (North, South, East, and West). Hierarchical clustering of comorbidities was applied to characterise the correlation structure of the ten commonest comorbidities within these geographical regions. Subsequent multimorbidity phenotypes (MMP) and their clinical features were then defined. Data were available for 2690 severe asthma patients and 23 comorbidities from 11 countries. Three comorbidity clusters were consistently seen across the four European regions: 1) osteoporosis plus stero
Associations between gastroesophageal reflux disease and otolaryngological diseases.
Xiao Y, Zhang H, Zhang F, Luo J, Zhao X, Liu H · Medicine · 2025
In this study, we conducted a 2-sample Mendelian randomization (MR) analysis to explore the relationship between gastroesophageal reflux disease (GERD) and 16 common otolaryngological diseases. Single-nucleotide polymorphisms that are strongly associated with GERD were used as instrumental variables. The primary estimation of the causal effect utilized the inverse variance weighting method, supplemented by MR Egger, weighted median, simple mode, and weighted mode as alternative methods for estimating the causal effect. Then, sensitivity analyses, including heterogeneity, pleiotropy, and leave-one-out analyses, were performed to verify the robustness of the results. The analysis of MR showed that genetically predicted GERD was associated with an increased risk of acute upper respiratory infection (odds ratios [OR] = 1.1418, 95% confidence intervals [CI] = 1.0664-1.2225, P = 1.00 × 10-4), chronic pharyngitis (OR = 
Lab and in-vitro work explaining how something might work.
Role of chromatin remodeling complex SWI/SNF and VDR in chronic rhinosinusitis.
Kowalik K, Waniewska-Łęczycka M, Sarnowska E, Rusetska N, Sierdziński J, Zagor M · Advances in clinical and experimental medicine : official organ Wroclaw Medical University · 2020 · n=52
The SWI/SNF (SWItch/sucrose non-fermentable) chromatin remodeling complex enables glucocorticoid receptor (GR) and vitamin D receptor (VDR) to function correctly and is engaged in inflammation response. The SWI/SNF may play an important role in chronic rhinosinusitis (CRS). The aim of this study was to assess the following: 1) the gene and protein expression of the SWI/SNF complex subunits in sinonasal mucosa; 2) relation of SWI/SNF complex and VDR expression; and 3) correlation with clinical data. The study population consisted of 52 subjects with CRS without nasal polyps, 55 with CRS with nasal polyps and 59 controls. The SWI/SNF protein expression level was analyzed in immunohistochemical (IHC) staining. Human nasal epithelial cells (HNECs) was stimulated using lipopolysaccharide (LPS), Staphylococcal enterotoxin B (SEB) and vitamin D3 (vitD3) in vitro. The transcript level of the SWI/SNF subunits was measured with polymerase chain reaction (PCR). In the control group, the intens
Preclinical animal research — not a substitute for human evidence.
Langerude L, McQuiston A, Atkinson C, Mulligan JK · International forum of allergy & rhinology · 2025
Smoking has been shown to be associated with circulating deficiencies in 25(OH)D3 and reduced sinonasal tissue levels of the active form of vitamin D, 1,25(OH)2D3. Given vitamin D's ability to reduce inflammation, we sought to examine if intranasal (IN) delivery of calcitriol [clinical analog of 1,25(OH)2D3] could reduce inflammation and improve disease severity in a murine model of chronic cigarette smoke-induced sinonasal inflammation (CS-SI). Mice were exposed to CS 5 h/day, 5 days/week for 9 months, and then began IN calcitriol three times per week for 4 weeks. Micro-CT was used to assess disease severity. Sinonasal tissues were collected for RNA-seq analysis. Olfactory function was assessed using a T-maze odorant avoidance sniff behavior test. Nasal lavage fluid (NALF) was used for cytology and cytokines analysis. Quantification of disease severity by micro-CT showed IN calcitriol reduced opacification by 18%, as compared to smoke cessation alone, in which only a 5% reduction wa
Sinus Reformation for Management of Maxillary Posterior Bone Atrophy.
Pérez Salazar F, Cariati P, Monsalve Iglesias F, Fraile Ruiz L, Martínez Martínez CH, Martínez Lara I · The Journal of craniofacial surgery · 2025 · n=170
Implant rehabilitation in the posterior maxilla with critical residual bone height (≤6 mm) requires maxillary sinus floor augmentation techniques, although controversy exists regarding the necessity of heterologous bone grafts. Although some protocols consider grafting essential for osteogenesis, recent evidence suggests that modern implants, through a "tent-pole" effect, may eliminate this need, thereby avoiding its drawbacks (increased cost, surgical time, and risk of complications such as sinusitis). This retrospective study compares implant survival and complications between both techniques in patients with 4 to 6 mm of bone height undergoing immediate implant placement. In this comparative retrospective study, 170 patients with posterior maxillary atrophy (4-6 mm residual bone height) undergoing lateral approach sinus lift with immediate implant placement were analyzed. Patients were divided into 2 groups: 80 patients without bone graft (group A) and 90 pati
Public-health agencies: NCCIH, NIH, CDC, NHS.
NHS
The NHS provides comprehensive information on sinusitis, covering symptoms, causes, diagnosis, and treatment options for the general public.
Registered ongoing or completed trials (ClinicalTrials.gov).
n=50 · NCT00912405 · COMPLETED · COMPLETED
This study allows continued access to the Sinexus Intranasal Splint while a marketing application is being prepared. This study will generate additional performance, reimbursement and safety data for the steroid-eluting Sinexus Intranasal Splint when used following Functional Endoscopic Sinus Surgery (FESS) in patients with chronic sinusitis (CS).
Photodisinfection for the Treatment of Chronic Rhinosinusitis
n=48 · NCT01854619 · UNKNOWN · UNKNOWN
The purpose of this study is to determine whether the use of light and a topically applied photosensitizer can relieve symptoms and clinically improve patients with chronic rhinosinusitis.
n=140 · NCT02975310 · RECRUITING · RECRUITING
Chronic rhinosinusitis, also called chronic sinusitis, is a very common life-long disease affecting over 5% of the Canadian population. Its symptoms, including daily facial pain and headache, an inability to breath through the nose and complete smell loss, regularly impair one's ability to work and to enjoy and participate in daily activities. The annual cost of chronic sinusitis to Canada is estimated at $1.3 billion while the government pays an estimated $860 million yearly for chronic sinusitis treatment. Chronic sinusitis with polyps, the most common type of chronic sinusitis, is usually treated with a combination of medications and surgery. Until now, surgical treatment has only been performed in the operating room, at a cost of about $3500 per procedure. But, recent studies have shown that a new procedure, "in-clinic polyp removal", can provide an improvement in patient symptoms to levels equal to those for sinus surgery performed in a hospital operating room. Moreover, in clinic polyp removal has additional advantages including a shorter procedure recovery time, a significantly lower cost to the health care system (about one-tenth the cost or $450), and a shorter wait time for treatment. With the proposed pragmatic trial, the investigators will determine whether the in clinic polyp removal procedure is as good as sinus surgery in the operating room at controlling patient symptoms of chronic sinusitis. The investigators will also determine the cost and health-benefits for a patient, the healthcare system and for society of in clinic polyp removal in comparison to sinus surgery done in a hospital operating room. The investigators will then know if this new treatment, in clinic polyp removal, can replace sinus surgery as the standard of care for these patients.
Curated cross-source summaries (TRIP Database and similar).
TRIP Database
TRIP Database is a clinical search engine that allows users to find high-quality research evidence on chronic sinusitis. It aggregates evidence from various sources, including guidelines, systematic reviews, and clinical trials.
Cochrane
The Cochrane Library hosts systematic reviews and meta-analyses related to sinusitis, offering high-quality evidence to inform clinical decisions.
Conventional treatment for chronic sinusitis often includes nasal corticosteroids, saline nasal rinses, antibiotics for bacterial infections, and sometimes oral corticosteroids. In cases unresponsive to medical therapy, surgical interventions like endoscopic sinus surgery may be considered to improve drainage and ventilation of the sinuses.
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