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1. How can I tell the difference between a cold and sinusitis?

   A cold that doesn't go away in a week or so may have developed into sinusitis. If you have sinusitis, you will have unusually thick nasal or postnasal drainage that is yellowish-green, a cough (which might get worse at night), pain in your cheeks, forehead and around your eyes, a headache and maybe a fever.

2. How do I know if I have chronic sinusitis or acute sinusitis?

   After taking a medical history and conducting a physical examination, a health care professional should be able to diagnose whether you have acute or chronic sinusitis. You might have nasal polyps or a deviated septum, which are causing the sinusitis. But generally speaking, if you have frequent episodes of acute sinusitis or if your symptoms never completely go away, you probably have chronic sinusitis. If you have the symptoms and sinus inflammation that persists for three weeks or more, you should see a health care professional.

3. What causes chronic sinusitis?

   Chronic sinusitis can be caused by a variety of different things, including a blockage of the sinus openings, problems with the movement of mucus, or a weakness in the immune system. It can become a vicious circle. An allergy or an infection (a cold, for example) can inflame your sinuses. Because of the inflammation, the sinus membranes get thicker, causing more of a blockage. Eventually, your sinuses may be blocked completely.

   Noxious chemicals, cigarette smoke, pollution, dust, mold and even strong perfume can exacerbate sinus symptoms. Another possible cause of chronic sinusitis just may be structural. If you have narrow drainage passages in your nose, a deviated septum or nasal polyps, medications will only temporarily alleviate your symptoms.

4. Is surgery the best option?

   Surgery is used only if all other therapies fail and is almost always an elective procedure The most common sinus procedure is called functional endoscopic sinus surgery (FESS), in which the natural openings from the sinuses are enlarged to allow more drainage. During the surgery, which takes anywhere from one to three hours, a surgeon uses an endoscope to look directly into your nose, remove diseased tissue and polyps if necessary and clear the passages from the sinuses. This outpatient procedure can be done using local or general anesthesia and is less invasive than conventional sinus surgery. Patients rarely have serious complications.