Chronic Rhinosinusitis
If you’ve had a blocked nose, facial pressure, nasal discharge or reduced sense of smell for months rather than days, you may be suffering from chronic rhinosinusitis.
Unlike a simple cold or short-term sinus infection, chronic rhinosinusitis (CRS) is a long-term inflammatory condition of the nose and sinuses that often requires specialist ENT care.
At Hampshire ENT Clinics, The Harbour Suite at Queen Alexandra Hospital, and Medicana Winchester, we provide comprehensive assessment and modern treatment for chronic rhinosinusitis for patients across Portsmouth, Southampton, Winchester and Salisbury.
👃 What Is Chronic Rhinosinusitis?
Chronic rhinosinusitis is diagnosed when two or more sinus symptoms persist for 12 weeks or longer, including at least one of:
Nasal blockage or congestion
Nasal discharge (front or postnasal drip)
Often alongside:
Facial pressure or pain
Reduced or lost sense of smell
CRS is driven by ongoing inflammation, not persistent infection — which is why repeated antibiotics often provide little benefit.
🤧 Common Symptoms
People with chronic rhinosinusitis may experience:
Constant blocked or congested nose
Thick nasal mucus or postnasal drip
Facial pressure (cheeks, forehead, between the eyes)
Reduced sense of smell or taste
Headaches
Fatigue and poor sleep
Symptoms that worsen with colds
Recurrent “sinus infections”
Symptoms often fluctuate but rarely disappear completely without targeted treatment.
🔍 What Causes Chronic Rhinosinusitis?
CRS is usually multifactorial. Contributing factors include:
Chronic inflammation of the nasal lining
Allergic rhinitis
Nasal polyps
Narrow sinus drainage pathways
Deviated nasal septum
Enlarged turbinates
Asthma and Type 2 (eosinophilic) inflammation
Aspirin sensitivity
Previous sinus infections
Your ENT specialist will assess which factors apply to you.
🩺 How Is Chronic Rhinosinusitis Diagnosed?
Assessment at Hampshire ENT Clinics, The Harbour Suite or Medicana Winchester may include:
Detailed symptom history
Nasal endoscopy (camera examination of the nose and sinuses)
CT scan of the sinuses
Allergy assessment (where appropriate)
This allows accurate classification into:
CRS with nasal polyps (CRSwNP)
CRS without nasal polyps (CRSsNP)
Treatment is tailored accordingly.
💊 Medical Treatment for Chronic Rhinosinusitis
Most patients start with medical therapy, including:
Steroid nasal sprays to reduce inflammation
Saline rinses to clear mucus and allergens
Short courses of oral steroids in selected cases
Targeted treatment for allergies
Management of asthma or reflux if contributing
CRS often requires long-term maintenance treatment, not short courses.
🛠️ Procedural and Surgical Treatments
If symptoms persist despite optimal medical therapy, further options include:
1. Endoscopic Sinus Surgery
Minimally invasive surgery to:
Open blocked sinus drainage pathways
Remove inflamed tissue or polyps
Improve delivery of nasal treatments
Image-guided navigation is used in complex or revision cases.
2. Turbinoplasty
Reduces chronically swollen nasal tissue to improve airflow.
3. Clarifix® Cryotherapy
Targets overactive nasal nerves in patients with persistent rhinitis and postnasal drip.
4. Biologic Therapy
For selected patients with severe CRSwNP and Type 2 inflammation:
Reduces polyp size
Improves smell and breathing
Reduces need for surgery and oral steroids
Delivered through specialist ENT-led pathways.
🌟 Living Well With Chronic Rhinosinusitis
With the right treatment plan, most patients achieve:
Improved nasal breathing
Fewer flare-ups
Better sleep and energy
Improved sense of smell
Reduced reliance on antibiotics
CRS is a chronic condition, but it is highly manageable with expert care.
🏥 Why Choose Hampshire ENT Clinics
Patients choose our services because we offer:
Consultant-led rhinology expertise
Full access to medical, procedural and surgical treatments
Modern facilities
Convenient access
Care for patients across Portsmouth, Southampton, Winchester and Salisbury
Individualised, evidence-based treatment plans
👉 If you’ve had sinus symptoms for more than 12 weeks, contact Hampshire ENT Clinics or Medicana Winchester for expert assessment and tailored treatment.
Frequently Asked Questions (FAQs): Chronic Rhinosinusitis (CRS)
What is chronic rhinosinusitis?
Chronic rhinosinusitis (CRS) is a long-term inflammatory condition of the nose and sinuses. It is diagnosed when sinus symptoms persist for 12 weeks or longer, rather than resolving after a short infection or cold.
How is CRS different from a sinus infection?
A simple sinus infection (acute sinusitis) is usually caused by infection and settles within days or weeks. CRS is driven primarily by ongoing inflammation, not persistent infection, which is why repeated antibiotics are often ineffective.
What symptoms suggest chronic rhinosinusitis?
Typical symptoms include:
Persistent nasal blockage or congestion
Ongoing nasal discharge or postnasal drip
Facial pressure or pain
Reduced or lost sense of smell
Fatigue and poor sleep
Symptoms often fluctuate but do not fully resolve without targeted treatment.
Do I need all the symptoms to have CRS?
No. CRS is diagnosed when two or more symptoms are present for at least 12 weeks, provided one is nasal blockage or discharge.
What causes chronic rhinosinusitis?
CRS usually has multiple contributing factors, including allergic rhinitis, nasal polyps, narrow sinus drainage pathways, deviated septum, asthma, and Type 2 (eosinophilic) inflammation. Your ENT specialist will assess which factors are relevant to you.
What is the difference between CRS with and without nasal polyps?
CRS with nasal polyps (CRSwNP) involves soft tissue swellings in the nose and sinuses and is often associated with asthma and loss of smell.
CRS without nasal polyps (CRSsNP) is more commonly associated with facial pressure and nasal blockage.
Treatment differs between the two.
How is chronic rhinosinusitis diagnosed?
Diagnosis may include a detailed history, nasal endoscopy (camera examination), and a CT scan of the sinuses. This allows accurate diagnosis and guides treatment decisions.
Do antibiotics help CRS?
Antibiotics have a limited role and are usually only used during acute flare-ups. Long-term control relies on anti-inflammatory treatments, not repeated antibiotics.
What medical treatments are available?
Most patients benefit from steroid nasal sprays, saline rinses, and tailored management of allergies, asthma, or reflux. Some patients may need short courses of oral steroids during flare-ups.
When is surgery considered?
Surgery is considered if symptoms persist despite optimal medical treatment. Endoscopic sinus surgery aims to improve drainage and allow medications to work more effectively—it does not cure inflammation but helps control it.
What is biologic therapy and who is it for?
Biologic treatments are advanced medications used for selected patients with severe CRS with nasal polyps and Type 2 inflammation. They can reduce polyp size, improve smell, and reduce the need for surgery or oral steroids.
Is CRS a lifelong condition?
CRS is a chronic condition, but with expert care it is highly manageable. Many patients achieve long-term symptom control and a good quality of life.
Where can I be assessed and treated?
Comprehensive assessment and treatment are available at Hampshire ENT Clinics, The Harbour Suite at Queen Alexandra Hospital, and Medicana Winchester, caring for patients from Portsmouth, Southampton, Winchester, Salisbury, and across Hampshire.
When should I seek ENT advice?
You should seek specialist assessment if sinus symptoms last longer than 12 weeks, keep recurring, affect your sense of smell, or significantly impact sleep or daily life.