What is chronic rhinosinusitis?
Chronic sinusitis or rhinosinusitis refers to sinusitis (inflammation of the sinuses) that has lasted more than 12 weeks. There are many types of chronic sinusitis but in broad terms we divide sinusitis into chronic sinusitis with or without nasal polyps.
The true cause for chronic sinusitis is still unknown. We believe it is “multifactorial” and is probably by a dysfunction in the interaction between the host (your body) and the environment (for example a bacteria or a virus). The nose normally is a delicate balance of normal bacterial flora. In some people a trigger causes this delicate balance to be upset and chronic sinusitis develops.
How do I know if I have chronic sinusitis?
The typical symptoms of chronic sinusitis are:
- nasal blockage, nasal obstruction, nasal congestion
- nasal discharge or post-nasal drip
- facial pain or headaches
- reduction or loss of smell
An ear, nose and throat specialist can perform nasendoscopy. Nasal polyps, infections and anatomical problems can be identified. Typically a CT scan is also needed.
Chronic sinusitis can rarely cause more serious problems if infection spreads beyond the nose to the meninges (meningitis), brain (encephalitis or abscess) or eyes (periorbital or orbital cellulitis).
Chronic sinusitis is managed differently depending on if there are nasal polyps. Some types of chronic sinusitis can be managed with a medicines. Your GP can prescribe a topical steroid spray, a course of antibiotics and some saline irrigations. Over a few weeks this will cure some types of chronic sinusitis.
Chronic sinusitis with polyps more frequently require surgery to create a sinus cavity that can be treated with topical medications.
When surgery is required for chronic sinusits it is called functional endoscopic sinus surgery. Sinus surgery for chronic sinusitis has evolved in recent years with some ear, nose and throat specialists being trained in the latest minimally invasive endoscopic sinus surgery (keyhole) techniques.
Dr Roth is an Ear, Nose and Throat surgeon with subspecialty training in the nose and sinuses. He is well versed in the most up to date manage of chronic sinusitis.