A blocked or runny nose with symptoms such as facial pain or impaired sense of smell for more than 3 months may indicate chronic rhinosinusitis. There are several treatment options.
Chronic rhinosinusitis is an inflammatory disease of the mucous membrane of the nose and paranasal cavities, which is defined by the presence of a combination of characteristic symptoms of the disease lasting longer than 12 weeks.
Diagnosing
It is about the presence of two or more symptoms, one of which must be nasal congestion or nasal secretion that can be on the nose, but also down the throat, which is very common in chronic rhinosinusitis. The remaining two symptoms are pain in the face, which is also described as a headache, and a disorder or complete loss of the sense of smell.
In addition to subjective symptoms, objective signs of inflammation found during a clinical examination or a CT scan of the paranasal sinuses, such as purulent secretions and swelling of the nasal mucosa, are also necessary for the diagnosis.
According to one classification, chronic rhinosinusitis appears in two clinical phenotypes, namely chronic rhinosinusitis without nasal polyps (to which this article is dedicated) and chronic rhinosinusitis with nasal polyps.
Causes of chronic rhinosinusitis
Chronic rhinosinusitis occurs as a result of the interaction of many factors such as genetic predisposition on the one hand and factors such as deformation of the nasal septum, long-term infection with some bacteria or fungi and allergies.
The basic disorder that causes inflammation of the sinuses is the blockage of their mouths. When the mouths are blocked, the constant movement of mucus on the surface of the sinus mucosa, a kind of cleaning of the sinuses and the exchange of air in the sinuses are prevented. Something like airing. This causes the swelling of the mucous membrane and the retention of secretions in the sinuses, which is suitable for the reproduction of various microbes.
The most common bacteria isolated in patients with chronic rhinosinusitis is Staphylococcus aureus, followed by some anaerobic bacteria. There are about twenty different fungi isolated from patients with chronic rhinosinusitis, and it is considered that Alternaria is the most significant in the development of this chronic inflammation.
Treatment of chronic rhinosinusitis
In the treatment of chronic rhinosinusitis, the first line is corticosteroid local therapy with sprays or nasal drops. Nasal hygiene is also very important, which is carried out by rinsing the nose with isotonic and hypertonic solutions. Rinsing with the so-called rhino horn is also useful, and inhalations of the mentioned solutions, which can be enriched with some medicinal plant extracts, also help.
The antibiotic is given only in case of exacerbation of chronic sinusitis, which manifests itself with general symptoms such as increased body temperature, poor general condition and changes in the blood count that indicate worsening of bacterial inflammation.
Today, great hopes are placed in biological therapy aimed at blocking the activity of some molecules (interleukins) that are known to play an important role in inflammatory processes in the mucous membrane of the nose and paranasal cavities.
Surgical treatment is indicated when the above conservative treatment is ineffective. Today’s surgical treatment method of choice is endoscopic sinus surgery. It is a minimally invasive method aimed at widening the mouth of the sinus. It is a very successful method which, however, does not contribute to the cure of chronic inflammation, but creates the anatomical preconditions for the inflammation to subside, and with it the symptoms of chronic rhinosinusitis.
Find more professional advice at the polyclinic for the diagnosis and treatment of ear, nose and throat diseases and for minimally invasive aesthetic surgery of the head and neck in Alba Rubra.
This text was created in collaboration with portal “ADIVA – your portal for health”
