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  • Definition: Inflammation or infection of the nasal passages and sinuses.
  • Acute Rhinosinusitis: Symptoms for less than 4 weeks.
  • Subacute Rhinosinusitis: Symptoms between 4-12 weeks.
  • Chronic Rhinosinusitis: Symptoms lasting more than 12 weeks.
  • Recurrent Acute Rhinosinusitis: 4 or more episodes per year without symptoms between episodes.
Aetiology/ Risk Factors
  • Upper respiratory tract infections.
  • Allergies.
  • Nasal polyps or tumours.
  • Deviated nasal septum.
  • Environmental factors: Smoke, pollution.
Clinical Features
  • Nasal congestion and discharge.
  • Facial pain or pressure.
  • Reduced sense of smell (anosmia).
  • Fever (more common in acute).
  • Halitosis.
  • Nasal Endoscopy: To visualise nasal passages and sinuses.
  • CT scan: Detailed imaging of sinuses, especially in chronic or complicated cases.
  • Cultures: If bacterial cause suspected.
  • Conservative: Saline nasal irrigation, steam inhalation.
  • Medical:
    • Analgesia (e.g., paracetamol).
    • Topical nasal corticosteroids (e.g., fluticasone).
    • Antibiotics (e.g., amoxicillin) for suspected bacterial cases.
    • Antihistamines for allergic rhinosinusitis.
  • Surgical: Functional endoscopic sinus surgery (FESS) for refractory or complicated cases.
  • Abscess formation.
  • Osteomyelitis of surrounding bones.
  • Meningitis or brain abscess (rare).
  • Orbital cellulitis.
Key Points
  • Rhinosinusitis can be due to a variety of causes, both infectious and non-infectious.
  • Management is often conservative, but antibiotics may be needed for bacterial cases.
  • Chronic rhinosinusitis may require surgical intervention.

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