Chronic Rhinosinusitis

Question 1

What is chronic rhinosinusitis?

Answer 1

Chronic rhinosinusitis is an inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer.

It affects up to 1 in 10 people.

Question 2

What are the predisposing factors for chronic rhinosinusitis?

Answer 2

Predisposing factors include: atopy (hay fever, asthma), nasal obstruction (e.g. septal deviation or nasal polyps), recent local infection (e.g. rhinitis or dental extraction), swimming/diving, and smoking.

Question 3

What are the features of chronic rhinosinusitis?

Answer 3

Features include facial pain (typically frontal pressure pain worse on bending forward), nasal discharge (usually clear if allergic or vasomotor, thicker purulent discharge suggests secondary infection), nasal obstruction (e.g. ‘mouth breathing’), and post-nasal drip (may produce chronic cough).

Question 4

What is the management for recurrent or chronic sinusitis?

Answer 4

Management includes avoiding allergens, using intranasal corticosteroids, and nasal irrigation with saline solution.

Question 5

What are the red flag symptoms of chronic rhinosinusitis?

Answer 5

Red flag symptoms include unilateral symptoms, persistent symptoms despite compliance with 3 months of treatment, and epistaxis.