Chronic Rhinosinusitis
Chronic Rhinosinusitis
Chronic rhinosinusitis is a long-term inflammation of the mucous membranes of the nose and paranasal sinuses.
There are two types of chronic rhinosinusitis: with polyps and without polyps.
Symptoms
The four main symptoms typical of chronic rhinosinusitis are:
- Difficulty breathing through the nose;
- Thick nasal discharge or drainage into the throat;
- A feeling of tightness and pain in the face;
- Partial or complete loss of smell.
- These symptoms should not last longer than 12 weeks.
Other possible symptoms include
- Ear pain;
- Headache;
- Tooth pain;
- Cough;
- Sore throat;
- Bad breath;
- Fatigue;
The symptoms of chronic rhinosinusitis are similar to those of acute rhinosinusitis. Still, acute symptoms typically last for a short time and are usually a complication of an acute viral infection.
When to see a doctor
Consult a doctor if you have recurring sinusitis that does not improve with treatment. Whether you experience acute or chronic symptoms of sinusitis, it is important to see an otolaryngologist for timely diagnosis and treatment planning.
See your doctor right away if you have symptoms that may indicate a serious infection:
- Fever;
- Swelling or redness around the eyes;
- Severe headache;
- Swelling of the forehead;
- Confusion;
- Double vision or other changes in vision;
- Stiffness in the neck (neck stiffness).
Some conditions can make chronic sinusitis worse:
A cold or other infection that affects the sinuses - viruses or bacteria can cause these infections;
A problem inside the nose, such as a deviated septum, nasal polyps, or tumors.
Risk factors
Risk factors for developing chronic sinusitis include:
- Dental infection;
- Fungal infection;
- Regular exposure to cigarette smoke or other pollutants.
Complications
Serious complications of chronic sinusitis are rare, but complications can include:
- Vision problems - Infections that spread to the eye socket can cause vision loss or blindness.
- Infections—Although infections are uncommon, serious infections in the sinuses can spread to the membranes and fluid around the brain and spinal cord, causing meningitis.
Prevention
Take the following steps to reduce your risk of developing chronic sinusitis:
- Take care of your health - Try to avoid contact with people who have viruses or other infectious diseases. Wash your hands often with soap and water, especially before eating.
- Monitor your allergies - Talk to your doctor often to keep your symptoms under control. Avoid contact with things you are allergic to.
- Avoid cigarette smoke and polluted air - Tobacco smoke and other pollutants can irritate the lungs and the lining of the nose, called the nasal passages.
- Use a humidifier - Artificially increasing the humidity in the air can help prevent sinusitis. Clean your humidifier regularly and thoroughly to prevent mold from forming.
Diagnosis
Diagnosis of chronic sinusitis includes:
Nasal endoscopy - The doctor inserts a thin, flexible tube, known as an endoscope, into your nose. The light from the tube allows the doctor to see the inside of your sinuses;
Imaging tests - A CT scan or MRI can visualize the details of your sinuses and nasal area. These images can help determine the cause of your chronic sinusitis.
Treatment
Treatment for chronic sinusitis includes:
- Nasal corticosteroids. These nasal sprays help prevent and treat congestion. Some are available over the counter. Examples include fluticasone (Flonase Allergy Relief, Xhance), budesonide (Rhinocort Allergy), mometasone (Nasonex 24HR Allergy), and beclomethasone (Beconase AQ, Qnasl, and others).
- Nasal irrigation with saline solutions. This home treatment, called nasal lavage, can help clear your sinuses.
- Corticosteroid injections or tablets. These medications relieve symptoms of severe sinusitis, especially in people with nasal polyps.
- Allergy medications. Taking allergy medications can help reduce symptoms of sinusitis caused by allergies.
- Medications to treat nasal polyps and chronic sinusitis. If you have nasal polyps and chronic sinusitis, an injection of dupilumab (Dupixent), omalizumab (Xolair), or meoplisumab (Nucala) may reduce the size of your nasal polyps and relieve your nasal congestion.
