Acute & Chronic Sinusitis
More than 37 million Americans suffer from at least one episode of acute sinusitis each year. The prevalence of sinusitis has soared in the last decade possibly due to increased pollution, urban sprawl, and increased resistance to antibiotics. Acute sinusitis is used to describe a condition where one develops facial pain along the sinuses, infected discharge from the nasal cavities and low-grade fevers. This condition can last up to 12 weeks and still be termed acute sinusitis. If the condition lasts longer than 12 weeks then we term it chronic sinusitis. Often times we use the term sinusitis interchangeably with the term rhinosinusitis. This is because we don’t separate the nasal and sinus mucosa from each other since they are contiguous with each other. (See Figure) Also we can see from the figure that there is a normal mucociliary flow within the nose and sinuses that allows mucus and debris to drain. However this flow can get disrupted from either anatomical obstruction (i.e. deviated septum, hypertrophic turbinates, polyps, etc.), ciliary dysfunction (i.e.smoking, aggressive surgery, etc.) or thick mucus consistency (i.e. cystic fibrosis). When this happens we get many of the symptoms of chronic rhinosinusitis.
Acute rhinosinusitis often can be treated without the need for surgery with such measures as oral antibiotics, intranasal steroid sprays, decongestants, nasal and sinus saline rinses with or without the need for oral steroids. However when dealing with chronic rhinosinusitis, an expert evaluation is recommended to determine the cause of the problem and possibly contemplate surgery to reverse the symptoms.
The symptoms of chronic rhinosinusitis can include some or all of the following:
- Nasal obstruction (usu. bilateral)
- Rhinorrhea or runny nose (usu. clear to yellow, thin)
- Hyperirritability (sneezing, etc.)
- Propensity for frequent acute sinus infections (> 3 per year)
- Sinus headaches / facial pain
- Smell and taste changes
The causes of chronic rhinosinusitis are listed below:
- Allergic (seasonal, perennial, occupational)
- Infectious (bacterial or fungal)
- Eosinophilic (non-allergic rhinitis with eosinophilia-NARES or sinonasaly polyposis-polyps)
Dr. Cohen will not only spend the time and energy to identify the cause of your chronic rhinosinusitis but will then formulate an individualized medical plan to treat your problem which may entail both medical and surgical therapies. As a result each patient at Southern California Sinus Institute will always understand the nature of their problem and will be knowledgeable about how to proceed with relieving their symptoms.
