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Chronic Sinusitis – Medical treatments

Could it be Chronic Sinusitis? Take the test to find out Back Follow-up your own pathwayMySinusitisCoach Medications for chronic sinusitis Chronic sinusitis is a broad diagnosis further classified based on the presence of nasal polyps. Depending on the subtype, the underlying cause, and the extent of disease, your doctor may use different therapeutic approaches to treat your chronic rhinosinusitis. Generally, The use of medication represents the first-line treatment, and Surgery is recommended as second-line treatment when medications fail to control symptoms. Nasal saline irrigation Saline rinsing (or douching) provides symptomatic relief by washing the nasal cavities, removing secretions, and rinsing allergens and irritants. The use of nasal rinsing with saline prior to administration of other nasal medications enables the medication to effectively reach the inner lining of the nasal mucosa. Nasal corticosteroids Corticosteroid nasal sprays (or topical steroid) are generally prescribed to reduce the inflammation by altering the actions of cells from your immune system. Common generic names of corticosteroids include fluticasone, mometasone, prednisone and triamcinolone. If polyps are present, corticosteroid treatment may shrink them. Oral corticosteroids If a nasal corticosteroid is not effective, corticosteroid may be prescribed orally. Because oral corticosteroids can cause important side effects, they are generally taken only for a limited period of time. Side effects may include osteoporosis, hypertension, diabetes, weight gain, and eye disorders, among others. Antihistamines If allergies cause to worsen your sinusitis symptoms, antihistamines may be prescribed to reduce the inflammation. In addition, it is recommended to avoid allergens to further reduce your sinusitis symptoms. Antibiotics Oral antibiotics may be prescribed in case of chronic and recurring infection of your sinuses. Certain antibiotics, such as macrolides and tetracyclines, have anti-inflammatory properties and further help reducing the inflammation. Biologicals Biologicals drugs are novel molecules which are currently being tested in patients with chronic rhinosinusitis with nasal polyps. Although not available yet, these drugs may be efficient to shrink and eliminate nasal polyps without surgery. Additional FAQs on medications What is the importance of treatment adherence? Lack of control in chronic rhinosinusitis is often,but not always, linked to the improper adherence to the prescribed treatment. It is important to follow the recommendation of your doctor in order to define the best therapeutic strategy for your chronic rhinosinusitis. Do I need antibiotics to treat my chronic sinusitis and for how long? In moderate to severe symptoms of chronic sinusitis, either with or without nasal polyps, long-term treatment with antibiotics can be prescribed for around 12 weeks. I don’t want to take steroid tablets as I have heard there are lots of side effects – is that true? Only steroid tablets can give side effects because they enter the blood circulation. Nasal sprays containing corticosteroids are not causing side effects since they are applied locally, without uptake in the blood circulation. Long-lasting intake of tablets with steroids can influence thyroid disease, dysregulate sugar levels -particularly in patients with diabetes-, cause osteoporosis and trigger depressive of agitated feelings. I need daily my nasal spray with steroids. Now I have eye problems. Can that be caused by my nasal spray? In some patients who have relatives that are affected by high eye pressure, nasal sprays with steroids might trigger development of these eye problems if overused. Generally eye symptoms are rarely caused by nasal sprays containing steroids. If there are doubts, patients should see an ophtalmologist for review. The nasal decongestant spray that I buy without prescription is much better in opening up my blocked nose, why can I not use it all the time? The nasal decongestant spray only works for a short period by decongesting the mucosa agressively. It should not be used longer than 5 consecutive days. If used over a longer period, it can have adverse effects like additional swelling and irritation of the mucosa and even cause dependance on this medicine. button-block-bgcheckcheckmarkCME badgeCMEcmebadgeCMEdownloadeuforeatveyefacebookfaqglobeicon_1icon_2icon_3Middel 1iconmonstr-facebook-1iconmonstr-info-8iconmonstr-linkedin-1iconmonstr-twitter-1iconmonstr-video-13iconmonstr-youtube-1infographic-blueinfographic-blueinfographic-bulbinfographic-darkblueinforgraphic-yellowinstagramlinkedinpdfpinterestquestionmarksmartphonespotifytweetstwitteryoutube Sinus surgery Surgery will be suggested by your doctor when maximal medical treatment has failed. By maximal medical treatment, we refer to different and adequate types of therapy, with medications that have proved their efficacy during large clinical trials. The standard surgical procedure for chronic rhinosinusitis is Functional Endoscopic Sinus Surgery. The aim for every patient who gets operated for chronic rhinosinusitis is to remove the disease in key areas, to restore adequate aeration and drainage of the sinuses, to remove nasal polyps if present, and overall to protect normal nasal functioning. More information about Sinus Surgery What the experts say about the treatments for chronic sinusitis: Related articles and video’s No related articles found Show more articles

Chronic Sinusitis – Symptoms & diagnosis

Could it be Chronic Sinusitis? Take the test to find out Back Follow-up your own pathwayMySinusitisCoach Symptoms of chronic sinusitis Chronic sinusitis (or chronic rhinosinusitis) is characterized by the presence of two or more of the following key symptoms for at least 12 consecutive weeks, one of which should be either: Nasal blockage; to have difficulty breathing through your nose Runny nose; discoloured and thick discharge from the nose or down into the throat This can be with or without: Facial pain/pressure Reduction of smell Some patients may also experience ear or teeth pain, bad breath, sore throat, irritability, and/or lack of energy. Take the self-assessment test to check your symptoms. Diagnosis of chronic sinusitis Chronic sinusitis is diagnosed based on the presence of the above key symptoms, and confirmed by either: Nasal endoscopy; looking with a camera inside the nose CT scan; a computed tomography scan Chronic sinusitis is a broad diagnosis that includes different subtypes of inflammatory disease, further classified based on the presence of nasal polyps. Other tests might be performed, such as smell test, sinus cultures and/or allergy tests. Additional FAQs related to the diagnosis of chronic sinusitis Could it be chronic sinusitis ? Self-Assessment Test Additional FAQs on diagnostic procedures What is the role of nasal endoscopy in the diagnosis of chronic sinusitis? Nasal endoscopy is indispensable in the diagnosis of chronic rhinosinusitis. It offers the advantage of a global evaluation of the nasal cavity and the outflow tracts of the sinuses visualising the potential presence of nasal polyps and/or secretions at this level. In case nasal endoscopy does not provide final diagnosis, a CT scan of the sinuses will generally be performed. Other tests might be performed, such as nasal patency measurements, smell test and/or allergy tests. How can loss of smell be tested? Smell can tested by in a subjective way by means of different smell tests such as UPSIT (University of Pennsilvania Smell Identification Test), Sniffin’ Sticks or Barcelona smell test. Additionally, there is a way to do an objective measurement by means of smell-evoked current measurements. These tests are in general supplemented by an MRI (scan) examination of the skull base in order to evaluate the olfactory bulbs (smell region in the brain). When and why is an X-Ray of the skull advised? X-ray (Röntgen radiation) of the skull or sinus in case of chronic (rhino)sinusitis is no longer advise. When and why is an MRI scan advised? MRI (magnetic resonance imaging) is an imaging modality that does not require radiation exposure. MRI instead uses a magnetic field and radio waves to create images in the area of concern within the body. MRI is often used to evaluate disease other than chronic rhinosinusitis or nasal polyps. The MRI scan will show more details on the type and size of a lesion and its relation with surrounding structures. This will help your ear-nose-throat (ENT)-doctor in making a diagnosis and a plan of treatment. When and why is a CT scan advised? A CT (computed tomography) scan is advised in case of chronic rhinosinusitis with or without nasal polyps or other disease in your nose/sinus that might indicate surgery or when the ear-nose-throat (ENT)-doctor is not sure about the diagnosis. The CT scan will not only show the severity and extent of disease and its relationships with other surrounding structures, but will also work as a map for the ENT doctor showing important anatomical landmarks during surgery. In summary, this information helps in making a diagnosis and in case of surgery it helps the ENT doctor in making a plan for the extent and techniques of surgery. Does a sinus CT scan cause much radiation? Are the scans necessary? Every CT scan gives radiation and for that reason it is important not to make unnecessary CT scans. Together with your ear-nose-throat (ENT)-doctor you can decide whether the CT scan is needed. Most hospitals use a low radiation dose protocol for CT scans of the sinuses. When these protocols are used, the amount of radiation you are exposed to during each scan is equivalent to few months of exposure to natural radiation from the environment or a transatlantic fligth (two-way). button-block-bgcheckcheckmarkCME badgeCMEcmebadgeCMEdownloadeuforeatveyefacebookfaqglobeicon_1icon_2icon_3Middel 1iconmonstr-facebook-1iconmonstr-info-8iconmonstr-linkedin-1iconmonstr-twitter-1iconmonstr-video-13iconmonstr-youtube-1infographic-blueinfographic-blueinfographic-bulbinfographic-darkblueinforgraphic-yellowinstagramlinkedinpdfpinterestquestionmarksmartphonespotifytweetstwitteryoutube What the experts say about the diagnosis of chronic sinusitis: Related articles and video’s No related articles found Show more articles

Chronic Sinusitis – Disease

Could it be Chronic Sinusitis? Take the test to find out Back Diseases of the sinuses What are the sinuses? Sinuses are air-filled cavities covered by a mucosal layer and located within the bones of your face and skull. The nose and sinuses are important for filtering, heating and moistening the air you breathe through your nose, which is an important function that protects your lungs. Sinus cavities may also contribute to voice resonance and can absorb energy to protect the brain from trauma. Acute or chronic sinusitis? Sinus diseases can be split into two categories: acute (rapid onset) or chronic (over a long period of time). Acute sinusitis is the most common form, and is characterized by a short infection or inflammation of the sinonasal mucosa, which resolves quickly after 1-2 weeks. On the other hand, chronic sinusitis symptoms last for more than 12 weeks. Types of chronic sinusitis Chronic sinusitis (also called chronic rhinosinusitis) is a broad diagnosis that includes different disease subtypes, further classified based on the presence of nasal polyps: Chronic rhinosinusitis with nasal polyps (CRSwNP) Chronic rhinosinusitis without nasal polyps (CRSsNP) Causes of chronic sinusitis Although not fully understood, chronic rhinosinusitis is usually caused by a combination of different factors that contribute to the development of the disease. It occurs due to a malfunctional interaction between individual patient characteristics (including genes) and environmental factors. Chronic sinusitis can arise due to: Respiratory infection Immune system disorders Allergic reaction to airborne antigens or to substances produced by certain bacteria and fungi Inhalation of small particles like cigarette smoke or pollutants Genetics What are nasal polyps? Causes, symptoms, and treatments Learn more Additional FAQs Difference between chronic sinusitis or chronic rhinosinusitis? Is chronic sinusitis inherited? Can chronic sinusitis be cured? Inflammation of the sinuses is often referred to as sinusitis. However, the term rhinosinusitis is preferred to sinusitis since the inflammation of the sinuses rarely occurs without simultaneous inflammation of the nasal mucosa. Both terms are commonly used interchangeably. Chronic sinusitis with nasal polyps runs in families but also chronic sinusitis without nasal polyps has been observed in family members, strongly suggesting that a hereditary (=genetic) factor contributes to the disease. However, studies in identical twins showed that both siblings will not necessarily develop nasal polyps, which emphasizes the additional and important role of non-hereditary, environmental factors. In general, this is a chronic disease that cannot easily be cured, however patients sometimes have long periods of well-controlled disease. The treatment aims primarily to control patient’s symptoms. Other goals are to reduce mucosal inflammation, to establish sinus drainage of secretions and to reduce sudden worsening of symptoms. Usually the disease becomes less severe after 60 years of age. Inflammation of the sinuses is often referred to as sinusitis. However, the term rhinosinusitis is preferred to sinusitis since the inflammation of the sinuses rarely occurs without simultaneous inflammation of the nasal mucosa. Both terms are commonly used interchangeably. Chronic sinusitis with nasal polyps runs in families but also chronic sinusitis without nasal polyps has been observed in family members, strongly suggesting that a hereditary (=genetic) factor contributes to the disease. However, studies in identical twins showed that both siblings will not necessarily develop nasal polyps, which emphasizes the additional and important role of non-hereditary, environmental factors. In general, this is a chronic disease that cannot easily be cured, however patients sometimes have long periods of well-controlled disease. The treatment aims primarily to control patient’s symptoms. Other goals are to reduce mucosal inflammation, to establish sinus drainage of secretions and to reduce sudden worsening of symptoms. Usually the disease becomes less severe after 60 years of age. Related articles and video’s No related articles found Show more articles Summary Diseases of the sinuses What are the sinuses Acute or chronic sinusitis? Types of chronic sinusitis Causes of chronic sinusitis Additional FAQs Difference between chronic sinusitis or chronic rhinosinusitis? Is chronic sinusitis inherited? Can chronic sinusitis be cured? FAQs The FAQs are designed to cover more in-depth questions, particularly interesting if your condition is long-standing. If you have any questions that remain unanswered after going through this portal and FAQs, don’t hesitate to contact our Team at contact@euforea.eu. Please note that we can’t take any personal questions. About CRS What is chronic rhinosinusitis (CRS)? Inflammation is the body’s reaction to things like germs and irritants such as foreign objects or chemicals. When inflammation affects the inside lining of the nose and spreads to the sinuses, it’s called rhinosinusitis. Sinuses are the air-filled spaces above the nose. Common symptoms of rhinosinusitis include pain or pressure in the face, changes in the ability to smell, and mucus that drips out of the front part of the nose or into the back of the throat. These symptoms are in addition to the usual symptoms of rhinitis, like a stuffy/blocked nose and extra mucus in the nose. When the symptoms of rhinosinusitis are present for more than 12 weeks, it is considered CRS. CRS can present with or without nasal polyps. Nasal polyps are soft, non-cancerous growths in the nose and/or sinuses that can cause symptoms and interfere with your daily life. To date, it remains unclear why some patients with CRS develop nasal polyps and others do not. The form of CRS with nasal polyps is also referred to as nasal polyp syndrome. Is CRS inherited? CRS with nasal polyps runs in families but also CRS without nasal polyps has been observed in family members, strongly suggesting that a hereditary (=genetic) factor contributes to the disease. However, studies in identical twins showed that both siblings will not necessarily develop nasal polyps, which emphasizes the additional and important role of non-hereditary, environmental factors. Why do I have sinuses? Sinuses are air-filled cavities in the bones of your face and skull that are covered with a thin moist layer of mucus. The nose and sinuses fulfil an important role in filtering, heating and moistening the air that we breathe through the nose. This is important to

Chronic Sinusitis – Surgery

Could it be Chronic Sinusitis? Take the test to find out Back Follow-up your own pathwayMySinusitisCoach When should sinus surgery be considered? If the medical treatments prescribed by your doctor fail to control your symptoms, sinus surgery may be suggested. How does sinus surgery work? The standard procedure for chronic rhinosinusitis is Functional Endoscopic Sinus Surgery (FESS). The goal for every patient undergoing sinus surgery is to remove the disease in key areas, to restore adequate aeration and drainage of the sinuses, to remove nasal polyps if present, and to restore normal nasal functioning. The surgeon will insert a small tube with a tiny camera into the nostrils and guide it into the sinus cavities. The diseased tissues will be removed using additional instruments. During the operation, the surgeon may also remove the disease in key areas in order to restore adequate aeration and drainage of the sinuses. Endoscopic surgery is usually performed as an outpatient procedure. Benefits of surgery Sinus surgery offers a significant improvement of patient’s quality of life. In particular, sinus surgery will relieve most of the symptoms that are attributable to chronic sinusitis such as nose obstruction, runny nose, nasal secretions in the throat, and facial pain. The effects of surgery on reduced smell vary strongly between patients and depend on the extent of the disease. Surgery is also expected to improve patient’s sleep quality, work performance and daytime fatigue. Risks & complications of surgery Sinus surgery is a challenging procedure and despite the availability of new instrumentation, complications during surgery may still occur. The major complications include bleeding, intracranial injury (inside the skull), and visual disturbances. Examples of minor complications include effusion of blood around the eye (‘blue eye’) or redness of the skin around the eye, watery eyes, scar formation inside the nose and persistence of the disease. What the experts say about Sinus Surgery: Symptoms recurrence after sinus surgery In approximately 20% of patients undergoing surgery, symptoms will recur. Poorer surgical outcomes were shown in patients with: Asthma Sinusitis where the upper (frontal) sinuses are affected Aspirin-exacerbated respiratory disease (AERD) Exposure to occupational agents Best post-operative care The best post-operative care after a sinus surgery is intensive and frequent rinsing of the nose and sinuses with large amounts of saline water and (re-)starting your nasal medication, for instance nasal corticosteroid sprays. You will also see your ENT doctor more frequently during the first weeks to months after sinus surgery. These extra visits are used for cleaning your nose and sinuses for example of blood crusts and giving extra care if necessary. Patient testimonials: surgery for curing chronic sinusitis? Additional FAQs on Sinus Surgery Is Sinus Surgery painful? Pain in the post-surgical period is very uncommon and it is considered a sign of persistent inflammation. However, every patient is different and depending on the extent of your surgery, the usage and type of nasal sponge that is used to prevent or control bleedings inside the nose, you may experience some discomfort, congestion and headache during the early recovery period. In such case, your doctor will prescribe painkillers for the first few days. How fast will I recover after sinus surgery? Most nasal symptoms improve after sinus surgery. Recovery from sinus surgery is individual and depends on your health and type of procedure, but most people need to be away from work or school for several days. Once your nose and sinuses are healed, you should be able to resume your normal activity level. You will have some swelling and soreness inside your nose after the surgery, but this is normal. Likely your doctor may recommend nasal rinsing with saline to manage your symptoms after surgery. Will surgery solve my sinus problems forever? Since chronic sinusitis is a chronic inflammatory disease surgery cannot free you from the disease forever. Even after sinus surgery continuous medical treatment is necessary for lifetime since asymptomatic disease persists. Additionally, in approximately 20% of patients undergoing surgery, symptoms will recur and revision surgery might be indicated. Can sinus surgery be performed on children? In general, we tend to be much more conservative when treating children than adults with chronic sinusitis. Sinus surgery during childhood is preserved for really serious conditions such as persistent disease in patients with cystic fibrosis as well as orbital (eye) and intracranial (inside the skull) complications. What is the impact of sinus surgery on asthma? Treating symptoms of chronic rhinosinusitis by surgery can improve symptoms of asthma, as the inflammation of your sinuses (upper airways) and the inflammation of your lungs (lower airways) are related. button-block-bgcheckcheckmarkCME badgeCMEcmebadgeCMEdownloadeuforeatveyefacebookfaqglobeicon_1icon_2icon_3Middel 1iconmonstr-facebook-1iconmonstr-info-8iconmonstr-linkedin-1iconmonstr-twitter-1iconmonstr-video-13iconmonstr-youtube-1infographic-blueinfographic-blueinfographic-bulbinfographic-darkblueinforgraphic-yellowinstagramlinkedinpdfpinterestquestionmarksmartphonespotifytweetstwitteryoutube Related articles and video’s No related articles found Show more articles

Chronic Sinusitis – Follow up

Could it be Chronic Sinusitis? Take the test to find out Back What to expect and when to visit… the general practitioner A “common cold” should resolve within one to maximum two weeks. Chronic symptoms of the nose and sinuses last longer than that and if the symptoms do not resolve completely after 1-2 weeks or if there is an transient improvement and subsequent worsening the patient is advised to see a general practitioner. the ENT (ear-nose-throat) doctor Chronic sinusitis is primarily treated by the primary care physician who usually advices nasal rinsing with saline and prescribes a nasal corticosteroid spray. If the disease is not controlled the patient can be referred to an ear-nose-throat (ENT)-doctor. Not controlled means that with the applied treatment the patients still has symptoms and impairment of quality of life. In unclear cases and thus unclear diagnosis of chronic sinusitis by the primary care physician the patient can also be referred to an ENT doctor. the pharmacist Pharmacists are also members of the multidisciplinary team that can offer help in treating chronic sinusitis. They have knowledge about different drugs and can give useful advices on how to use nasal sprays. Some pharmacists can also advice you on how to perform nasal rinsing with salt water. The pharmacist will also stress the fact that a consequent use of nasal sprays with corticosteroids is essential to achieve the maximal benefit from this drug. Additionally, counselling about the temporal effects of nasal sprays with corticosteroids can also be giving by the pharmacist. Patients should know that it might take some days before they start to notice the beneficial effects of nasal sprays with corticosteroids and that the effect is not instantly like for example with decongestive sprays. However, to make a proper diagnosis and to get the follow-up needed, you must also see a doctor and ideally an ear-nose-throat (ENT)-doctor. Partnering with your doctor to better treat your chronic condition Related articles and video’s No related articles found Show more articles Summary What to expect and when to visit… the general practitioner the ENT (ear-nose-throat) doctor the pharmacist Partnering with your doctor to better treat your chronic condition

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