What is rhinosinusitis?

Definition:

Rhinosinusitis is inflammation of the nasal passages (rhinitis) and sinuses (sinusitis), often caused by infection, allergies, anatomical anomalies etc.

Epidemiology

1. Prevalence: Rhinosinusitis affects approximately 10-15% of the global population.

2. Age: Rhinosinusitis can occur at any age, but it's more common in adults.

3. Sex: Women are more likely to develop rhinosinusitis than men.

Pathophysiology

1. Infection: Viral, bacterial or fungal infections can cause rhinosinusitis.

2. Allergies: Allergies to pollen, dust, or other substances can trigger rhinosinusitis.

3. Anatomical abnormalities: Deviated septum, nasal polyps, or other anatomical issues can contribute to rhinosinusitis.

4. Miscellaneous factors: Factors such as nasal packing for epistaxis, passage of nasogastric tube for therapeutic purposes.

Symptoms and signs

1. Nasal congestion: Stuffy or blocked nose.

2. Yellow or green nasal discharge or post nasal drip: Thick, discolored mucus.

3. Facial pain: Pain or pressure in the cheeks, forehead, or eyes.

4. Headache: Frequent or severe headaches.

5. Loss of smell: Reduced or complete loss of sense of smell.

6. Cough: Persistent or severe cough.

7. Fatigue: Feeling tired or exhausted.

8. Halitosis: Having a bad breath.

Investigations

1. Physical examination: Nasal endoscopy or rhinoscopy.

2. Imaging tests: Computed tomography (CT) or magnetic resonance imaging (MRI) scans. CT is the gold standard tool for investigations.

3. Allergy testing*: Skin prick test or blood tests.

4. Nasal swabs*: To identify bacterial, fungal or viral infections

Management of rhinosinusitis.

Medical Management

1. Antibiotics: For bacterial infections.

2. Decongestants: To relieve nasal congestion.

3. Steroid nasal sprays: To reduce inflammation.

4. Antihistaminces: For allergies.

5. Analgesics: For headache, facial pains

Surgical Management

1. Endoscopic sinus surgery: To remove blockages or growths.

2. Septoplasty: To correct deviated septum.

3. Turbinate reduction: To reduce nasal congestion.

Lifestyle Changes

1. Nasal saline irrigation: To clear nasal passages.

2. Humidifiers: To add moisture to the air.

3. Avoid allergens: Identify and avoid triggers.

4. Quit smoking: Smoking can exacerbate rhinosinusitis.

Complications

1. Orbital complications: The most common complications

2. Chronic sinusitis: Persistent or recurring sinus infections.

3. Nasal polyps: Growths in the nasal passages.

4. Asthma: Rhinosinusitis can trigger or worsen asthma.

5. Meningitis: Rarely, rhinosinusitis can spread to the brain and cause meningitis.

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