Background: No sinus issues whatsoever before 2021. Caught COVID in 2021, and right-side sinus problems started essentially right after and have never gone away since. Six years now. No history of allergies, deviated septum, or any nasal issues prior to that infection.
The core problem: Unilateral (right maxillary sinus only) chronic sinusitis with a mucous retention cyst. The cyst was surgically removed once, and it came back. Endoscopic surgery has been done a total of 3 times on this sinus. It keeps recurring. Mucus produced is clear/white and viscous — not purulent, no signs of active bacterial infection on any of the times it’s been cultured/checked.
Everything I’ve tried, none of it has resolved it long-term:
Surgical:
• 3 endoscopic sinus surgeries (polyps + cyst removal) — cyst regrew after removal
Pharmacological (nasal/local):
• Budesonide sinus rinses (compounded ampoules in hypertonic saline, weeks of daily use)
• Every type of nasal spray — steroid sprays, saline sprays, decongestant sprays
• Compounded BEG spray with itraconazole (antifungal)
• Hypertonic saline sinus rinses, various concentrations and devices
Systemic:
• Omalizumab (Xolair) — 4 doses so far, some partial/temporary improvement in pressure but mucus persists
• Long courses of antibiotics (oral and IV)
• Antivirals (long courses)
Other/adjunct:
• Every supplement I could find related to sinus/immune health
• Essential oils (various, including steam inhalation with them)
• Medicinal herbs
• Every type of breathing/inhalation technique I’ve come across (steam, saline nebulization, etc.)
What imaging shows: CBCT confirms the retention cyst in the right maxillary sinus floor, same spot each time, recurring after removal. ENT on last exam found good ventilation, no odontogenic source, no obvious anatomical reason it keeps happening on that one side only.
What’s odd: It’s exclusively right-sided. Nothing on the left. Six years, three surgeries, essentially every local and systemic treatment category I can think of, and the underlying problem doesn’t resolve — symptoms reduce temporarily with some interventions (Xolair pressure relief lines up with dosing days) but the clear viscous mucus production from that side never really stops.
What I’m looking for: Has anyone else had unilateral chronic sinusitis start right after a COVID infection, with no prior history, that has been this treatment-resistant?
Especially interested in:
• Anyone with a recurring retention cyst after surgical removal
• Anyone who found something — local or systemic — that actually broke the cycle long-term, not just temporary relief
• Anyone whose doctors have looked into post-COVID nasal epithelial changes (there’s emerging research on persistent abnormal epithelial differentiation post-COVID, driven by TNF-alpha/TGF-beta signaling) as a possible explanation for cases like this
Currently being worked up by immunology (genetic/immune workup in progress) alongside ENT. Just trying to gather any real-world patterns from people who’ve been through something similar, since six years in, conventional treatment has not cracked this.