Chronic Sinusitis: Symptoms, Diagnosis, and Treatment Options

Sinusitis

Previously, I experienced severe yellow nasal discharge from my left nostril along with a sore throat.
Initially, I thought it was just a cold, and after visiting a general clinic, the sore throat resolved, but the nasal discharge continued.
I then consulted an otolaryngologist, who noted on the chart that I had chronic sinusitis.
After taking medication for three days with no improvement, I returned for a follow-up, received another prescription, and was referred to a city hospital for X-rays and a CT scan.
The imaging showed that the left sinus appeared white, indicating it was filled with mucus and other debris.
The doctor mentioned that it might require endoscopic surgery for cleaning.
Before my morning examination at the hospital, I felt that the amount of nasal discharge had decreased, and after returning home, I noticed that I was no longer experiencing nasal discharge.
Why is this happening? Could it be that the debris has become too thick to drain out? Is it urgent to undergo surgery, or would it be better to finish this course of medication and then have another check-up? Thank you, doctor.
^^

Jiang, 20~29 year old female. Ask Date: 2008/02/23

Dr. Hong Guangliang reply Otolaryngology

Hello, generally speaking, chronic sinusitis refers to sinus inflammation lasting more than three months with the presence of yellow or green nasal discharge.
Due to poor response to medication, surgical intervention may sometimes be necessary to address the issue of nasal pus.
Your symptoms do indeed appear to be consistent with sinusitis; however, whether surgery is absolutely required will depend on the clinical observation and judgment of the physician.
My recommendation is to complete the medication prescribed by your doctor and ensure you return for a follow-up appointment for a reevaluation of your condition!

Reply Date: 2008/02/23

More Info

Chronic sinusitis, also known as chronic rhinosinusitis, is a condition characterized by prolonged inflammation of the sinuses, which can lead to a variety of symptoms and complications. Understanding the symptoms, diagnosis, and treatment options is crucial for effective management of this condition.

Symptoms of Chronic Sinusitis
Chronic sinusitis can manifest through a range of symptoms, which may include:
1. Nasal Congestion: Persistent blockage or stuffiness in the nasal passages.

2. Discolored Nasal Discharge: Often yellow or green, indicating infection or inflammation.

3. Facial Pain or Pressure: Particularly around the cheeks, forehead, and eyes.

4. Reduced Sense of Smell: Hyposmia or anosmia may occur due to nasal obstruction.

5. Cough: Often worse at night, which can disrupt sleep.

6. Throat Irritation: Postnasal drip can lead to a sore throat.

7. Fatigue: Chronic inflammation can lead to a general feeling of tiredness.

8. Ear Pain or Pressure: Due to the interconnectedness of the sinuses and ear structures.

Diagnosis of Chronic Sinusitis
Diagnosis typically involves a combination of clinical evaluation and imaging studies. A healthcare provider will assess symptoms and may perform a physical examination, often using a nasal endoscope for direct visualization of the nasal passages and sinuses. Imaging studies such as X-rays or CT scans are crucial for identifying sinus blockage, fluid accumulation, or other abnormalities.

In your case, the CT scan showing white areas in the left sinus suggests the presence of fluid or mucus, which is consistent with chronic sinusitis. The accumulation of thick mucus can lead to further complications if not addressed.

Treatment Options
Treatment for chronic sinusitis may vary based on the severity and underlying causes. Common approaches include:
1. Medications:
- Nasal Corticosteroids: To reduce inflammation and swelling in the nasal passages.

- Antibiotics: If a bacterial infection is suspected or confirmed.

- Saline Nasal Irrigation: To help clear mucus and allergens from the nasal passages.

- Decongestants: To relieve nasal congestion.

2. Surgery: If medical management fails, surgical options such as functional endoscopic sinus surgery (FESS) may be considered. This procedure aims to remove blockages and improve sinus drainage.

3. Lifestyle Modifications: Staying hydrated, using a humidifier, and avoiding allergens can help manage symptoms.

Your Situation
Regarding your specific situation, it’s not uncommon for symptoms to fluctuate. The reduction in nasal discharge could be due to several factors, including the effectiveness of the medications you’ve taken or changes in mucus viscosity. Thick mucus can sometimes become stagnant and may not flow easily, leading to a temporary decrease in symptoms.
It’s essential to follow up with your healthcare provider to discuss your symptoms and the results of your imaging studies. If your symptoms persist or worsen, further evaluation may be necessary. In some cases, surgery may be warranted to clear out the sinuses and prevent future infections.

In conclusion, chronic sinusitis is a manageable condition, but it requires a comprehensive approach to treatment. Regular follow-ups with your healthcare provider are crucial to monitor your condition and adjust treatment as necessary. If you have any concerns about the need for surgery or the effectiveness of your current treatment plan, do not hesitate to seek a second opinion or further evaluation from an ENT specialist.

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