Rhinosinusitis

Sinusitis Sinusitis affects 31 million Americans annually. Chronic sinusitis is defined as unrelenting symptoms >12 weeks in duration. Major Symptoms Nasal / Post-nasal drainage* Facial pain / pressure* Nasal obstruction / congestion* Hyposmia / anosmia Cough not due to asthma (in children) *most common symptoms Minor Symptoms Fever Cough Fatigue Maxillary dental pain Ear fullness/pressure Headache

Sinus Anatomy Ethmoid sinusSuperior turbinate Middle turbinate Inferior turbinate Maxillary sinus Frontal sinus Maxillary sinus opening

Sinus Anatomy Sphenoid sinus

Sinus Evaluation

Causes of Sinusitis Wide spectrum of responsible causes –Allergy –Immunology –Bacteria –Fungus –Polyps –Anatomic blockage

Treatment of Sinusitis Treat underlying causes –Allergy allergy testing Antihistamine (Claritin, Zyrtec, Allegra) Nasal steroid spray (Flonase, Nasocort, Rhinocort) Immunotherapy –Inflammation Oral steroids –Infection Antibiotics

Nasal Saline Irrigation Moisturizes the nasal passage Improves the functioning of nasal and sinus lining Helps wash and remove inhaled allergens and irritants

Indications for Surgery Chronic sinusitis, >12 weeks duration –Symptomatic –Unresponsive to medical therapy Recurrent acute sinusitis? Sinus tumors/masses/polyps GOAL: to relieve blockage of sinuses to establish better drainage. Medical treatment, especially for allergies, may still be required after surgery.

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