Introduction
Sinusitis is a condition of inflammation of the paranasal sinsus’s. The paranasal sinus’s are air filled spaces located in the skull. There are multiple named paranasal sinuses, they are as follow:
- Maxillary sinus – located immediately under the eyes
- Frontal sinus – located above the eyes
- Anterior ethmoid sinus’s
- Posterior ethmoid sinus’s
- Sphenoid sinus – located under the base of the brain
Causes of sinusitis
The exact cause of sinusitis is unknown, but it is an inflammatory condition which causes an immune reaction within the paranasal sinus’s. Sinusitis is sub classified as either sinusitis with polyps or sinusitis without polyps. These conditions involve a different inflammatory pathway and a significant amount of research is ongoing as to the exact cause of sinusitis. Current theories surrounding the cause of sinusitis and disease modifiers of sinusitis include:
- Infectious
- Inflammatory
- Bacterial biofilms
- Immune system interaction
- Anatomical abnormalities
- Allergy
- Fungal
- Superantigens
Symptoms
The symptoms of sinusitis are:
- Nasal obstruction – blocked nose
- Runny nose
- Post nasal drip – feeling of mucus dripping down the back of throat
- Anosmia / hyposmia – loss of sense of smell or reduction in sense of smell
- Facial pain / pressure
To have sinusitis you have to have one of your symptoms as either nasal obstruction or runny nose or post nasal drip.
When you see Dr Robinson he will use a nasoendoscope to examine your nose to facilitate making the diagnosis of sinusitis. This will reveal either pus, mucus or polyps in the nose. Following this Dr Robinson will arrange for a CT scan of your sinus’s. If this demonstrates changes consistent with sinusitis then Dr Robinson will initiate treatment.
Tests
The most useful test for diagnosing sinusitis is a CT Scan of your paranasal sinus’s. The findings that are usually seen on CT Scan include fluid, or polyps within the nose. Other investigations including MRI Scan’s, swabs and blood tests are not indicated in the first instance.
Treatment Options
Treatment for sinusitis depends on multiple factors, whether you have sinusitis with polyps or without polyps and the degree of symptoms which you have. As a general rule treatment includes:
- Saline nasal wash
- Intranasal steroids
There may be a requirement for use of either a 6 weeks course of antibiotics or alternatively a reducing dose of steroids at the time of diagnosis. Dr Robinson will normally continue the medical treatment for sinusitis for a total of 6 weeks prior to considering surgical intervention. If surgery is indicated, then Dr Robinson will recommend functional endoscopic sinus surgery. The goal of the surgery is to open all of the involved sinus’s to facilitate delivery of medication to the lining of the nose.
Sinusitis is an area in which Dr Robinson sub-specialises and he ensures that he stays up to date with the latest treatment which is available for this condition by attending rhinological conferences as well as reading rhinological journals.
If you would like to further discuss sinusitis then contact his rooms to make an appointment with him.
