Chronic Rhinosinusitis Explained

Chronic rhinosinusitis is termed an inflammation that affects the paranasal sinuses. It was previously termed chronic sinusitis. This condition affects nearly 1 to 5% of the United States population. Chronic rhinosinusitis pathophysiology in adults and children differs significantly, making it vital to understand the disease and formulate the best treatment plan.

Chronic rhinosinusitis can reduce the quality of life of a patient. In addition, Americans use millions to billions annually to treat chronic rhinosinusitis and its associated complications. Here is an in-depth explanation of chronic rhinosinusitis, its symptoms, causes, prevention, and the various treatment approaches.

Definition

Chronic rhinosinusitis is a common infection that affects the sinus and blocks the regular draining of mucus. This results in nose stuffiness or block that makes breathing through your nose challenging. Unlike acute sinusitis, chronic rhinosinusitis is clinically diagnosed if it occurs over a long duration, at least 12 weeks. It is divided into two subtypes based on the absence or presence of nasal polyps.

Symptoms

Since chronic rhinosinusitis symptoms need to occur in not less than 12 weeks, you might have trouble tasting or smelling food. In addition, you might find dry mucus obstructing your nasal passages, green or yellow-colored mucus, facial tenderness, and postnasal drip. To diagnose chronic rhinosinusitis, one needs to show at least two of these symptoms.

Other signs and symptoms of chronic rhinosinusitis include:

• Tooth and jaw soreness
• Halitosis (bad breath)
• Exhaustion
• Nausea
• Headaches because of the swelling and pressure in the sinuses
• Throat soreness

Risk Factors

Several factors may increase the likelihood of a person developing chronic rhinosinusitis. Such factors include:

• Nasal polyps
• Aspirin sensitivity
• Asthma
• Dental infection
• Fungal infection
• HIV/AIDS and other immune system disorders
• Regular exposure to pollutants
• Smoking

Causes

Allergies are one of the causative factors of chronic rhinosinusitis, where chemicals and pollen cause nasal passages inflammation. Nasal polyps are tissue growth inside your nose that can block your sinuses and make breathing challenging. You can also have a deviated septum that limits airflow in your nostrils. This is because of the uneven walls of your nostrils.

Viral, bacterial, and fungal infections in your respiratory tract may promote the development of chronic rhinosinusitis. Respiratory infections can cause the nose to be inflamed, which blocks mucus drainage. Asthma may also cause chronic rhinosinusitis because it causes chronic inflammation in your respiratory system. Other diseases that may cause chronic sinusitis:

• Gastroesophageal reflux disease
• Human Immunodeficiency Virus
• Cystic fibrosis

Treatment

Several treatment options exist for chronic rhinosinusitis. The treatment options range from home remedies that offer temporary relief to surgical procedures. Your physician will assess your health status to determine the best course of treatment. Here are some of the options your physician may recommend:

Over the Counter Medications (OTC)

OTC pain relief medications, such as acetaminophen, diclofenac, and ibuprofen, may be used to alleviate headaches. Ibuprofen and diclofenac are non-steroidal anti-inflammatory drugs to relieve fever, pain, and inflammation.

Nasal Sprays and Irrigation

You may also get nasal sprays that contain corticosteroids to reduce inflammation. Nasal sprays will improve the airflow in your nostrils because it reduces the size of the polyps. Examples of OTC nasal sprays include fluticasone and mometasone.

Oral Corticosteroids

Studies have shown that oral corticosteroids aside from sprays can be used alone or in conjunction with other medications to treat chronic rhinosinusitis. It helps enhance sinonasal symptoms and the quality of life of the patient. Oral corticosteroids can be used as a short-term remedy in conjunction with intranasal corticosteroids sprays and nasal saline irrigation.

Antibiotics

If your chronic rhinosinusitis may be due to an infection, your physician might prescribe antivirals, antifungals, or antibiotics. The physician will need to differentiate between fungi, bacteria, and viruses. Furthermore, your physician will prescribe antimicrobial agents.

Home Remedies

You can use some home remedies to provide short-term relief to chronic rhinosinusitis. One of the best ways of promoting mucus flow is making salt and water lubricate your nostrils. This saline solution will help reduce swelling. Furthermore, you can inhale the warm steam or use a humidifier to decrease inflammation and drain mucus.

Surgery

When home remedies and conventional treatment fails, your doctor will refer you to a surgeon to treat the condition. Surgical options include:

Deviated Septum Surgery or Nose Surgery

Your surgeon might need to reshape the inner walls of your nostrils through septoplasty to correct a deviated septum. Alternatively, your surgeon might also conduct rhinoplasty to straighten and widen your nostrils to increase the space in your sinuses.

Endoscopic Sinus Surgery

Your surgeon may decide to conduct endoscopic sinus surgery. In this operation, your physician will insert a thin tube that contains a camera into your sinuses. The surgeon will examine the tissues, mucus, and polyps blocking your sinuses. Your surgeon will remove any tissues, mucus, or polyps that block mucus drain.

Complications

Although severe complications are rare after receiving treatment for chronic rhinosinusitis, vision problems may occur. If left untreated, chronic rhinosinusitis may cause damage to the olfactory nerve, which would cause permanent loss of smell. The infection may also spread to your bones and skin.

If the infection spreads from the sinus to the eye socket, you may experience reduced vision, leading to permanent blindness. Physicians have observed that some people may develop brain tissue and membrane inflammation.

Prevention

Doctors recommend that patients prevent chronic rhinosinusitis rather than incur the heavy financial burden of treating the infection. You may start by managing your allergies by avoiding triggers and substances that might cause chronic rhinosinusitis. Such substances, including nicotine, usually irritates lung tissue and promote inflammation. Thus, physicians recommend that you avoid smoking.

You can also consider installing a humidifier in your home to add moisture to the air might reduce the likelihood of chronic rhinosinusitis. However, it would be best to clean the humidifier regularly to avoid mold growth. It would help if you also avoided upper respiratory infections like colds by observing respiratory hygiene practices. In addition, you should regularly wash your hands with soap and running water.

Chronic rhinosinusitis comes with plenty of symptoms and signs that might not be that apparent. Although the disease is common, many people fail to notice or treat it. If you suspect that you have the ailment, you should visit our Philadelphia-based ENT doctor to diagnose and develop the best treatment plan.