Tuesday, March 14, 2017

Chronic Sinusitis

Scan showing sinuses/sinusitis
Chronic Sinusitis, also commonly referred to as Rhinosinusitis, is a recurring condition causing inflammation of the nasal passages in addition to mucus buildup, causing a vast array of symptoms. Chronic sinusitis has a reported prevalence of 5% in Canada, which increases with age, as well an increased prevalence in individuals with other chronic health conditions such as asthma and COPD (Chronic Obstructive Pulmonary Disease.) 

The symptoms of chronic sinusitis, the common cold and allergies can all be similar. Each of these conditions can cause the patient to have a congested or runny nose, headache, cough, ear pain/pressure, and even fatigue. When trying to determine whether you have chronic sinusitis, Vancouver physicians like Dr. Ali Ghahary will perform routine examinations by checking to see if you have tenderness in the nose or face and will also ask if you have discolouration of nasal discharge or nasal obstruction, which may oftentimes be indicative of a sinus infection. To confirm a suspect sinus infection, your physician may give you a requisition for an X-Ray, which can often be done by walking into any Radiology clinic without any appointment necessary, or send you for a CT Scan or MRI, which is typically done by appointment at any Vancouver or Lower Mainland hospital. These kinds of imaging scans will help to detect deep inflammation within the sinuses as well as confirm whether or not any infection is present, and will help guide your physician on the appropriate treatment required.

Nasal Polyps
Causes of chronic sinusitis include nasal polyps (growth of tissue that blocks the sinuses and/or nasal passages), a deviated or damaged septum (restricts or blocks the nasal passages), and respiratory infections (can be viral, bacterial or fungal.) Other medical conditions such as gastroesophageal reflux and other immune system related disorders have also been linked to the development of chronic sinusitis. You are also at a greater risk of developing chronic sinusitis if you have asthma or are exposed to pollutants such as smoke (or secondhand smoke.) Serious complications of chronic sinusitis include vision problems, potential or complete loss of your sense of smell, and meningitis.

Treatment of chronic sinusitis is dependent on the symptoms and their level of severity. If less than 7 days, chronic sinusitis is typically treated symptomatically; with intranasal corticosteroids (such as Nasonex) being prescribed in effort to help reduce inflammation and alleviate the symptoms you may be experiencing. Other treatment may include immunotherapy (allergy shots) to decrease the body’s reaction to certain allergens. If you are non-responsive to treatment or if the duration of symptoms is greater than 7 days (in addition to imaging showing a present infection), the likelihood of a bacterial infection increases and physicians like Dr. Ali Ghahary will then consider prescribing antibiotics to the patient. In recurring cases, as well as with persisting severe symptoms, a referral to an Ear, Nose and Throat specialist in Vancouver (or the surrounding area) may be required to determine if any further treatment, such as Endoscopic sinus surgery, is necessary. Endoscopic sinus surgery is usually done as a last resort when treatment has not been effective, and will remove any inflamed tissue or nasal polyps, as well as enlarge narrow sinus openings to help sinus drainage.


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  3. Chronic Sinusitis: symptoms of sinusitis occur frequently or for long periods and likely to have recurring attacks of acute sinusitis, which can be quite difficult to deal with.

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