Introduction

Sinusitis is a condition of inflammation of the paranasal sinuses. The paranasal sinuses are air-filled spaces that are located within the skull. There are multiple named paranasal sinuses, they are as follows:

• Maxillary sinus – located immediately under the eyes.
• Frontal sinus – located above the eyes.
• Anterior ethmoid sinuses.
• Posterior ethmoid sinuses.
• 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 that causes an immune reaction within the paranasal sinuses. 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.

Symptoms

The symptoms of sinusitis are:

• Nasal obstruction – blocked nose.
• Runny nose.
• Post-nasal drip – feeling of mucus dripping down the back of the throat.
• Anosmia / hyposmia – loss of sense of smell or reduction in sense of smell
• Facial pain / pressure.

To have sinusitis your symptoms must include either nasal obstruction, a 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 sinuses. 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 sinuses. The problems that are usually identified on CT scans include fluid, or polyps within the nose. Other investigations including MRI scans, swabs and blood tests are not indicated in the first instance.

Treatment

Treatment for sinusitis depends on multiple factors, whether you have sinusitis with polyps or without polyps, and the degree of symptoms you have. As a general rule treatment includes:

• Saline nasal wash.
• Intranasal steroids.

There may be a requirement for either a 6-week course of antibiotics, or 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 before 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 the involved sinuses to facilitate the 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.

Related Information

Functional Endoscopic Sinus Surgery (FESS)

To discuss fixing your sinusitis, please make an appointment with Dr Dan Robinson.