Nearly 40 million Americans experience at least one episode of sinusitis each year. Factors such as allergy and air pollution are contributing to an increased incidence of the disease. Broadly defined, sinusitis is an inflammation of the lining of the sinus cavities while rhinitis is inflammation of the mucosa lining the the nasal cavity.
Causes of nasal and sinus inflammation include infection, allergy, and chemical or particulate induced irritation. Acute sinusitis is a short-term condition that may be self limited. Symptoms can be relieved with the use of decongestants, and when appropriate, antibiotics are prescribed. Recurrent acute sinusitis may require additional evaluation and treatment similar to chronic sinusitis. Chronic sinusitis is considered when a patient suffers more than 12 weeks of symptoms such as facial pain/pressure, nasal congestion, discolored nasal discharge, and on occasion, headache, bad breath, smell loss, or fatigue. Unlike acute sinusitis, low grade fever and rapid onset of severe symptoms are usually not present.
Care for patients with chronic sinusitis first involves an evaluation for causes. Two major factors are considered : mechanical obstruction of the sinuses preventing adequate aeration, and chronic irritation, infection , or allergies resulting in swelling of the nasal and sinus linings. Nasal endoscopy and CT scans may be employed in the evaluation of altered nasal and sinus anatomy. A detailed patient history and when appropriate, allergy evaluation , are conducted to determine causes of inflammation.
Treatment for chronic sinusitis usually first involves maximizing medical management before considering surgical intervention. Prolonged antibiotic therapy as well as oral medications used to reduce inflammation and topical nasal therapies may be prescribed. Specific allergy desensitization therapy is also considered. Nasal and/or sinus surgery is recommended for patients with demonstrated mechanical obstruction not amenable to management with medications.
Nasal and Sinus Care at VCU
The Department of Otolaryngology/Head and Neck Surgery department at VCU provides comprehensive nasal and sinus care. A coordinated effort to assess and treat sinonasal disorders includes office endoscopy, allergy evaluation and therapy, and one of the few smell and taste disorders clinics in the country. In the operating room, the surgical team can employ the most advanced techniques and devices including powered instrumentation and computer assisted image guided sinus surgery equipment .
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