It is defined as inflammation of the mucosa of paranasal sinuses caused by a variety of disease processes. It is a common condition and a significant cause of morbidity.
Common symptoms are facial pain or headache, nasal congestion, nasal discharge, postnasal drip, chronic cough, malaise, fetid breath and hyposmia.
Following conditions may predispose to sinusitis:
- Nasal polyps
- Allergic rhinitis, Non allergic rhinitis
- Repeated upper respiratory infections
- Environmental pollution
Drainage of the nasal sinuses can be blocked by obstruction at the sinus opening or swelling of the nasal mucosa. Stagnation of mucus in the sinuses creates a favorable environment for bacterial growth that further contributes to mucosal inflammation. Sinusitis is rarely life threatening, although serious complications can occur because of the extension of infection to orbit and brain.
The goals of treatment are to reduce swelling of nasal mucosa, promote sinus drainage and eradicate infection. This often requires a combination of topical or oral corticosteroid, decongestant, antibiotics and nasal irrigation with salt water. In some patients the disease is so extensive or associated with co-existing pathologies that medical treatment is ineffective and surgery is required.
The goal of surgery is to re-establish sinus ventilation by opening and widening the blocked sinus ostia and to restore the normal function of the mucociliary system. Functional Endoscopic Sinus Surgery is the procedure of choice for the treatment of sinusitis. It restores sinus health with complete relief of symptoms in over 80% of patients and majority of patients report a significant improvement in their quality of life. Supportive medical treatment is required in the form of nasal douches and nasal sprays.