Chronic rhinosinusitis represents a multifactorial inflammatory disorder, rather than simply a persistent bacterial infection.  The medical management of chronic rhinosinusitis is now focused upon controlling the inflammation that predisposes patients to obstruction, reducing the incidence of infections. However, all forms of chronic rhinosinusitis are associated with impaired sinus drainage and secondary bacterial infections. Most individuals require initial antibiotics to clear any infection and intermittently afterwards to treat acute exacerbations of chronic rhinosinusitis.
Aging weakens the nasal sidewalls and causes the tip of the nose to sag. These changes can obstruct airflow inside the nose. Weak cartilage or cartilage turned inward can also predispose patients to nasal valve obstruction. The primary cause of nasal valve obstruction requiring surgery is previous nasal surgery. Taking down a large bump or decreasing a large tip can weaken support in the rest of the nose. Dividing the cartilage from the septum can cause scarring in the internal valve area that is very difficult to correct. Cosmetically, the nose may look great, but your breathing is still problematic. This can be avoided by choosing a surgeon trained to avoid and correct this deformity.
Sinus headaches are the result of swelling, inflammation or infection in one or some of the sinuses in your head. Many sinus headaches exhibit the same symptoms as tension headaches or migraines, but often have additional symptoms such as congestion, cough, sore throat, fatigue, or nasal discharge. They can be triggered by allergies, pressure changes in the ear, tooth infection, a cold, a bacterial sinus infection, or sinusitis.  While it is important to consult your doctor to accurately diagnose the type of headache you are experiencing, there are a number of different ways you can treat a sinus headache using both medical and home remedies. In general, most sinus headaches and swelling are gone within four to eight weeks with or without medical treatment.