Sinusitis and infections have been my number one problem as well. I also read somewhere that frequent sinus infections was sometimes a prelude to a later Sjogren's diagnosis.
Sadly, I was treated for many years like my problem was environmental allergies. I did have that problem, but now I don't think it was ever severe. What I had was a dryness problem, so when my body would respond to an environmental allergen, dryness made it difficult to flush it away like most people's bodies do.
3 Sinus Surgeries - the last one helped because it finally allowed me to use a nasal rinse. Previously, I would do a nasal rinse and some of the water would just get stuck and seem to make things worse. After this last surgery, I was able to flush my sinuses and this seemed to be enough of an improvement to prevent sinus infections for almost a year or so.
I had told my ENTs and Allergists that my nose was always dry - none of them mentioned to me that dryness might be a cause of the problem.
Then I started doing allergy shots, thinking that was the underlying problem and I think it made things worse. I took antihistamines which would make me even more dry but I didn't realize that was the issue. Budesonide in the nasal rinse did seem to be somewhat helpful.
I tried just about everything over the counter and every prescription allergy med, - and then tried Sinus Buster capsaicin nasal spray. This seemed to help in the moment, and prevented a sinus infection or two - but did not completely solve my issue. My experience with that spray is when the light finally came on - and I wondered if my underlying problem of sinus infections might be dryness, since what Sinus Buster did was make my eyes/sinus "water" because of the capsaicin.
Reading up a bit, I learned about Evoxac. After a few different doctors said they would not prescribe it for me, I finally convinced a doc to let me try it. Now 9 months on Evoxac and no sinus infections. I do one nasal rinse per day and take Evoxac. I also run a humidifier near my head at night, and now look to keep more humidity in the air instead of trying to get rid of it to keep dust mites away.
No idea how long this panacea will last but right now I'm just enjoying the moment.
Best Wishes