Chronic sinusitis treatment in Amman: Doctors and Clinics

Chronic sinusitis, more accurately chronic rhinosinusitis, is persistent inflammation of the lining of the nose and sinuses lasting twelve weeks or more. Diagnosis requires ongoing symptoms together with an objective finding seen on nasal endoscopy or on a CT scan. There are four cardinal symptoms: nasal obstruction, anterior or posterior discharge, facial pressure or pain, and reduced or absent sense of smell. Symptoms alone, without an objective finding, are not sufficient to make the diagnosis.

Treatment always begins with structured medical therapy rather than surgery: regular saline nasal irrigation, a topical intranasal steroid spray used for an adequate period determined by the clinician, and management of contributing factors, which matter a great deal. These include allergic rhinitis, asthma, cigarette and waterpipe smoking, gastro-oesophageal reflux, infected roots of the upper molars, a severely deviated septum and immune disorders. Antibiotics are reserved for evidence of bacterial infection or an acute exacerbation, at the clinician's decision, and are not a long-term treatment.

Functional endoscopic sinus surgery is an option for patients who have not improved after adequate, properly adhered-to medical treatment. Correctly understood, it widens the natural drainage pathways and removes diseased tissue to open a route for ventilation and for topical medication; it is not removal of the sinus, nor a definitive one-off cleaning. This is why saline irrigation and sprays continue afterwards: surgery makes topical treatment more effective rather than replacing it.

The limits should be stated plainly: sinus surgery does not cure allergy or asthma, it does not prevent colds, it does not guarantee that nasal polyps will not return in patients with severe inflammation, and the sense of smell may not fully recover if it has been lost for a long time. Headache is also not always sinus-related; much facial heaviness is due to migraine or tension-type headache and will not improve with surgery. A CT scan is likewise not indicated for every cold or headache, but according to clinical criteria.

A widespread myth needs correcting: there is no procedure that permanently cleans or suctions out the sinuses in a single session. Saline irrigation is useful and safe but is not a substitute for assessment. Decongestant sprays that open the nose immediately cause rebound congestion and worse obstruction if used for more than a few days. Suitability for any treatment or surgery is determined by clinical examination and nasal endoscopy, not by reading about it.