Chronic sinusitis

Chronic Sinusitis
Other names	Chronic rhinosinusitis
Specialty	Otolaryngology
Symptoms	Nasal blockage, facial pain, nasal discharge, reduced sense of smell, cough
Complications	Asthma, Meningitis, Anosmia, Orbital cellulitis
Duration	More than 12 weeks
Types	With or without nasal polyps
Causes	Infections, allergies, air pollution, structural abnormalities in the nose
Risk factors	Asthma, Cystic fibrosis, Aspirin exacerbated respiratory disease, immune system disorders
Diagnostic method	Based on symptoms, medical imaging, nasal endoscopy
Differential diagnosis	Acute sinusitis, Allergic rhinitis, Nasal polyps
Prevention	Smoking cessation, hand washing, managing allergies
Treatment	Nasal irrigation, nasal corticosteroids, antibiotics, surgery
Medication	Nasal corticosteroids, Saline nasal irrigation, Antibiotics
Prognosis	Variable
Frequency	Common

Chronic sinusitis, also known as chronic rhinosinusitis, is a common condition characterized by inflammation of the sinuses that lasts for at least 12 weeks, despite treatment attempts. This condition significantly affects the quality of life, leading to persistent symptoms such as nasal blockage or congestion, facial pain or pressure, nasal discharge, reduced sense of smell, and cough.

Causes

Chronic sinusitis can be caused by several factors including persistent infections, allergies, exposure to air pollution, and structural abnormalities in the nasal passages or sinuses. It may also be associated with other medical conditions such as asthma, cystic fibrosis, aspirin exacerbated respiratory disease, and various immune system disorders.

Symptoms

The primary symptoms of chronic sinusitis include:

• Persistent nasal congestion or blockage
• Facial pain or pressure, often worsening when bending forward
• Nasal discharge that may be yellow or green
• Reduced sense of smell and taste
• Cough, which may be worse at night

Diagnosis

Diagnosis of chronic sinusitis is typically based on the clinical history and physical examination. Additional diagnostic tools include:

• Nasal endoscopy, which allows direct visualization of the sinus openings
• Medical imaging, such as CT scan or MRI, to assess the extent of sinus involvement and to rule out other conditions
• Allergy testing, to identify underlying allergic conditions that may contribute to sinus inflammation

Treatment

Treatment of chronic sinusitis focuses on reducing sinus inflammation, treating underlying causes, and alleviating symptoms. Common treatments include:

• Nasal irrigation or saline sprays to flush out irritants and mucus
• Nasal corticosteroids to reduce inflammation
• Antibiotics for bacterial infections, though their use is controversial and should be targeted based on culture results
• Surgery, such as functional endoscopic sinus surgery (FESS), to remove obstructions and improve sinus drainage

Prevention

Preventive measures for chronic sinusitis include avoiding known allergens, smoking cessation, and maintaining good hand hygiene. Managing allergies and avoiding upper respiratory infections can also help prevent exacerbations of chronic sinusitis.

Prognosis

The prognosis for chronic sinusitis varies. Many individuals experience periods of exacerbation and remission. With appropriate management, most people can control their symptoms and maintain a good quality of life.