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Nasal polyps usually occur in persons with a history of allergies including asthma and allergy to aspirin. They appear as pearl-like swellings inside the nostril that may obstruct breathing and may impair the sense of smell and taste. If one or more polyps obstruct drainage from the sinuses, chronic sinus infection may occur. Surgical removal under local anesthesia may be warranted to relieve obstruction, but polyps are prone to recur. Rarely are polyps in the nose malignant when they are associated with allergic problems.

Acute sinusitis usually is treated by re-establishing drainage of the sinuses, relieving pain, and controlling or eliminating the cause of inflammation.

Decongestants may be recommended to help your sinuses drain. Nonprescription pain relievers may be advised to reduce headache and facial pain caused by sinus inflammation. And antibiotics often are prescribed to kill the bacteria causing the inflammation.

If you have chronic symptoms, your doctor may use nasal endoscopy to examine your nasal passages and the openings into the sinuses. Your nose is numbed with topical anesthetic and a thin, flexible, lighted tube is inserted.

Chronic sinusitis usually is more difficult to treat. Your doctor may prescribe a broader spectrum antibiotic that kills more types of bacteria. Treatment also may last longer. Antibiotics usually don’t cure chronic sinusitis, especially if it’s caused by obstructions in your nose or sinuses. And decongestants may not help your sinuses drain if you have chronic sinusitis.

To help, your doctor may prescribe medications that thin your mucus (mucolytics) and that help it drain even when swelling or obstruction narrows sinus openings. Steroid nasal sprays sometimes are prescribed to help reduce chronic inflammation. More severe cases may require corticosteroid pills to combat the inflammation in the sinuses.

Rinsing your nasal passages with a mild saline solution also may help. When medical treatment does not work, surgery may be advised. Functional endoscopic sinus surgery (FESS) is the most common surgical treatment for chronic sinusitis.

FESS enlarges the opening between your nose and your sinuses, improving drainage. In the procedure, special instruments shave away polyps and remove any other abnormal tissue. Eighty percent to 90 percent of people who have FESS report significant improvement

Sinusitis — sinus infection or inflammation — may be mistaken for a lingering cold. It may last only a couple of weeks, or it can linger for months, even years. And although it can be just a harmless irritation, sinusitis can lead to serious infections of adjacent bones and even the brain.

Sinusitis often mimics a cold — fever, fatigue, congestion, runny nose and sore throat. But it has a different cause and treatment.

A cold usually improves within a week and is all gone within 2 weeks. Typically, it doesn’t require medical attention. Sinusitis often lasts longer and is much more likely to need treatment. If you suspect you have a sinus infection, you should talk to your doctor.

Sinusitis is caused by anything that blocks sinus drainage or prevents cilia from sweeping properly. Predisposing factors for acute sinusitis include:

Colds — Most acute sinus infections develop when you’re getting over a head cold. You start to feel better, then get worse. Cold viruses don’t cause bacterial sinusitis, but they set the stage by causing your sinus openings to swell shut.

Allergies — When you breathe in substances to which you’re allergic, your nasal passages swell, which can block the openings between your sinuses and your nose.

Smoking — Tobacco smoke can interfere with the action of cilia, inhibiting mucus drainage. You’re more likely to have resistant bacteria and poor treatment results if you smoke.

Chronic sinusitis (as well as recurrent and lingering acute sinusitis) can stem from the same factors associated with acute sinusitis. The following often are found in chronic sinusitis:

Fungal infections — A specific type of chronic sinusitis is called allergic fungal sinusitis. Microscopic fungi are normally present in your nasal passages.

Nasal polyps — These fleshy, grape-like growths can block ostia and prevent sinus drainage.

An insufficient opening between your sinuses and your nose — Unusually small ostia prevent normal drainage of mucus from the sinuses.

A deviated septum — If the wall of cartilage that divides your nose isn’t straight and centered, mucus may not drain efficiently. A deviated septum can be congenital or the result of an injury.

Chronic sinusitis is a difficult diagnosis to make. It may take several tests for a doctor to decide what type of problem a person might have.