Rhinitis and Nasal Polys

Question 1

What is rhinosinusitis?

Answer 1

Inflammation of the nose and paranasal sinuses.

Question 2

What must a patient have to be diagnosed with rhinosinusitis?

Answer 2

Two or more symptoms of:

1. Nasal blockage/obstruction
2. Congestion/nasal discharge
3. Facial pain/pressure
4. Reduction/loss of smell

Question 3

What are the types of allergic rhinosinusitis?

Answer 3

1. Seasonal
2. Perennial - throughout the year
3. Occupational

Question 4

What is this a presentation of?

Sneezing, pruritus, clear nasal discharge, bilateral red itchy eyes.

Answer 4

Allergic rhinosinusitis

Question 5

What is the treatment for allergic rhinosinusitis?

Answer 5

1. Allergen/irritant avoidance
2. Nasal saline irrigation
3. Loratadine 10mg OD
4. Intranasal corticosteroid sprays

Question 6

What is this a presentation of?
Middle aged male with bilateral watery rhinorrhoea, sneezing, purulent postnasal drip, nasal obstruction, mouth breathing, and snoring.

Answer 6

Chronic rhinosinusitis with nasal polyps

Question 7

What conditions is chronic rhinosinusitis with nasal polyps associated with?

Answer 7

Allergic rhinitis, cystic fibrosis, aspirin hypersensitivity, late onset asthma.

Question 8

What is the management for chronic rhinosinusitis with polyps?

Answer 8

1. Refer to ENT for anterior rhinoscopy/nasal endoscopy (urgent if unilateral)
2. Topical steroid drops for 2 weeks followed by fluticasone for 3 months.
3. Endoscopic sinus surgery if refractory to maximal medical management.

Question 9

What is the management for chronic rhinosinusitis without nasal polyps?

Answer 9

Nasal irrigation and intranasal steroids