We all know of someone who has had or is suffering from ‘sinusitis’. So what exactly is this? Sinuses or ‘Paranasal sinuses’ are normal air filled spaces in your facial bones which are connected to the nose and breathing passages. Symptoms The symptoms of sinusitis include recurrent nasal stuffiness or blockage, runny nose and thick nasal discharge, headaches and cheek pains. More extensive disease may present with pain in eyes, vision changes and meningitis as well. Unfortunately, many other conditions get labelled as sinusitis mainly because of a self diagnosis or a missed diagnosis. We commonly see patients with eye problems, migraine or simple nasal allergies being managed for their sinus problems. Therefore, a proper ENT examination along with the diagnositic modalities is needed to establish the condition and plan a correct treatment.  Causes of sinusitis Sinusitis may be infective in origin or may be due to complications of nasal allergies. Neglected and under treated nasal infections and sometimes tooth infections are the commonest causes of chronic sinusitis. Thus quick diagnosis and early treatment are essential. A subgroup is fungal sinusitis, which is caused by fungal growth inside the sinuses. Allergic processes produce nasal swellings, which present as nasal polyps or as secondary infection over the allergic nasal disease. Complications As the paranasal sinuses are located in the centre of the face between the eyes and just below the brain- any flaring up of the infection may cause it to spread to the eye and brain. Rhino-pulmonary syndrome is another condition we come across. This is mostly because of air-borne allergies affecting the chest in the form of bronchitis and asthma as well as causing sinusitis. Diagnosis Every little seasonal cold or a bout of sneezing is not sinusitis. A nasal symptom which is not easily treated with routine cold and flu therapy should be investigated for sinusitis. A visit to an ENT clinic is to be sought for severe or long lasting symptoms. A clinical examination along with nasal investigations such as CT scan for paranasal sinuses or CT PNS as the case may be are required to diagnose the condition. Treatment An adequate medical management with both oral and nasal medications is mostly needed to treat the condition. Sometimes we may need to treat the patient for a few weeks as well. It is important to note that the sinusitis caused by allergy will need anti-allergy medication even months after surgery to prevent its recurrence. Surgical treatment of sinusitis has developed like endoscopic sinus surgery using tools like microdebriders and coblation. These allow for accurate removal of the sinus disease while preserving the surrounding areas. For selective cases, even more minimally invasive modalities like balloon sinuplasty are available in which the sinuses disease is cleared using an angioplasty like balloon to permanently change the shape of the nasal sinus openings. Most surgeries require general anaesthesia for the comfort of the patient. It also allows us to safely remove disease in delicate areas of the inside of the nose. Patients need a follow-up for a few weeks to ensure complete healing.