Chronic Sinusitis - Symptoms, causes and treatment. Sinusitis with polyps, Fungal sinusitis

Chronic sinusitis is defined as inflammation of the paranasal sinuses which lasts more than 12 weeks.
Chronic sinusitis commonly is associated with other chronic diseases including allergies, and chronic infections, for example, repeated viral infections. nasal polyps, or deviated nasal septum.
Chronic sinusitis is commonly caused by bacterial colonization in paranasal sinuses.
The most common pathogens during chronic bacterial sinuses are: Staphylococcus aureus and gram-negative bacteria.
Risk factors for chronic sinusitis can be:
Environmental factors, such as dust, mold, and tobacco smoke, air pollution.
Diseases such as Cystic fibrosis, Or immunodeficiency conditions.
Chronic sinusitis often coexists with allergic rhinitis and asthma.
Signs and Symptoms:
The most important symptom of chronic rhinitis is facial pain and pressure.
Postnasal drip is also common, which means, mucus accumulation in the back of the nose, and eventually, it drips down the back of the throat.
Nasal Congestion, and hyposmia or anosmia are also common symptoms.
Chronic Sinusitis can be classified in 3 types.
1. Chronic sinusitis with polyps
2. Chronic sinusitis without polyps
and 3 , allergic fungal sinusitis.

Chronic Sinusitis with polyps is common among men. It typically develops in adulthood and is associated with loss of smell, asthma or aspirin sensitivity.

chronic sinusitis without polyps is more common among women.
it develops in childhood and is more associated with facial pain and bacterial infection.

Allergic fungal rhinosinusitis is also associated with polyps and occurs in young adulthood from warm, humid regions.

typically occurs
in patients in their 20s and 30s who are from warm, humid regions. Mucus is more greenish-brown color and has a peanut butter-like consistency. It contains fungal species, common hyphae from aspergillus.
Allergic fungal rhinosinusitis is resistant to medical treatments.

Diagnosis is made by Rhinoscopy. The imagining choice is a CT scan.
Treatment:
Avoid triggers and allergens.
Saline sprays and washes provide symptom relief, especially higher-volume saline washes are more effective.
Intranasal glucocorticoids, including mometasone and fluticasone sprays or higher-volume budesonide
rinses, are the mainstays of treatment.
Corticosteroids are more effective especially in sinusitis with polyps because corticosteroids reduce polyp size.
Antibiotics are frequently prescribed but their effectiveness is under question mark.
Moderate improvement was observed use of macrolides during 3 months in people with chronic sinusitis without polyps.
Antifungal agents have not shown benefit against any subtype of chronic sinusitis.
In the case of fungal rhinosinusitis, medical therapy is classically ineffective, surgery produces good
results, and patients should be treated with perioperative glucocorticoids.
Nasal irrigation: This involves using a saline solution to rinse out the sinuses and remove mucus and other debris.

By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index...
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