Chronic Rhinosinusitis: Diagnosis, Treatment and Prevention Information for Africans

By: Elizabeth Obigwe. Freelance Writer, with medical review and editorial support by the DLHA Team

Black woman holding bridge of nose in sinus pain

Highlights

• The definitive diagnosis of chronic rhinosinusitis (CRS) requires imaging and other tests.

• The condition can be readily managed by lifestyle changes, medications and surgery.

• You can prevent CRS by living a healthy lifestyle including quitting smoking, reducing exposure to environmental pollutants and boosting your immunity with healthy diet, good sleep and reducing stress.

• When neglected, chronic rhinosinusitis can lead to health complications.

Introduction

Chronic rhinosinusitis (CRS) is an inflammation of the tissues of the nasal passages and sinuses that lasts for 12 weeks or longer, despite attempts at treatment. The condition has multiple causes but allergies and infections are some of the common ones. It also causes severe symptoms like blocked and runny nose, loss of sense of smell and taste, tenderness and pain in the face, etc. Therefore, living with CRS can significantly impact your quality of life, affecting everything from sleep and productivity to overall well-being. 

Thankfully, there are various treatment options available for managing chronic rhinosinusitis. There are also some preventive measures you can take to protect yourself. This article will discuss these treatments and preventions alongside the diagnosis of CRS. 

How is Chronic Rhinosinusitis Diagnosed?

Your doctor may decide that you have CRS if you experience at least two of the major symptoms related to the condition for more than 12 weeks. Or, at least one of the major symptoms and two minor symptoms for the same duration.

In addition to this, you may undergo:

• Computed Tomography (CT) Scan: An imaging procedure that reveals the sinus linings and any mucus, inflamed/thickened tissue, or polyps within the sinus spaces.

• Nasal Endoscopy: A procedure that involves the use of a thin tube attached to a camera (an endoscope) to see inside the nose and sinuses. Samples can also be taken for examination under a microscope. The samples from the sinuses are used for diagnosis over those from the nose.      

Other Conditions that Share Similar Symptoms with Chronic Sinusitis

Some other conditions may have two or more symptoms similar to those related to chronic rhinosinusitis. So, before concluding that you have CRS, your doctor will have to exclude the possibility of these other conditions. They include:

• Asthma

• Sinus tumors

• Oral cavity infections

• Nasal and sinus papillomas

How is Chronic Sinusitis Treated?

The treatment of chronic sinusitis generally focuses on identifying and avoiding triggers, reducing inflammation and treating infections. Some treatment options are summarised below:

• Nasal steroids: CRS can be treated with nasal steroids only or together with nasal saline irrigation, especially for chronic sinusitis with nasal polyps. The treatment should last for about eight to 12 weeks. If there is no positive result after this time, your doctor may consider using a short course of oral steroids.

• Nasal saline irrigation: Although nasal saline irrigation is not as effective as nasal steroids, it is often helpful to add it to your treatment. It is also more effective when you apply it in high volume.

• Antihistamines: If an allergy is suspected, you will also need an antihistamine.

• Antibiotics: If your doctor notices a bacterial infection, they can prescribe antibiotics for you. 

• Oral steroids: Your doctor will discuss and help you to decide if you need oral steroids and how you should take them.

• Surgery: Surgery can be used to correct structural changes like deviated nasal septum and nasal polyps. A type of surgery known as functional endoscopic sinus surgery can be used to relieve obstructions, restore drainage and mucociliary clearance, and ventilate the sinuses. It is usually considered when other medical treatments fail.

Can I Prevent Chronic Sinusitis?

Chronic rhinosinusitis occurs due to different factors. Hence, to prevent it, these factors must be identified. 

• Avoid allergies: Allergies are a common cause of CRS and they differ from person to person. It is best to identify possible allergies and other environmental toxins that may cause you to develop CRS and avoid them.

• Boost your immunity: Immune deficiency, especially where there is a history of co-existing lower airway, ear or skin infections can increase your chances of developing CRS. Hence, it is important to pay attention to it. Some natural ways to boost your immunity are eating healthily, exercising, getting enough sleep and reducing stress. 

• Practise a healthy lifestyle: Smoking is linked with an increased risk of CRS due to its ability to irritate the lungs and nasal passage. Hence, it should be avoided. Also, good hygiene practices such as avoiding persons with colds and infections, and washing your hands often can help prevent CRS.

• Wearing of face mask: If you live, work or commute in environments with poor air quality due to dust, smoke, traffic or generator fumes etc., it is advisable to wear an adequate quality face mask to protect yourself from the pollutants, as these may trigger CRS.                                                                                                                                                                                                            

When Should I See a Doctor?

If your symptoms do not get better even with treatment, and last for more than 10 days, you should see a doctor. Also, if you experience severe symptoms such as facial pressure, severe headache, visual disturbance, stiff neck and confusion, you may need to see your healthcare provider immediately or visit a medical emergency centre near you. 

Conclusion

Chronic rhinosinusitis can present differently in people. Understanding these differences is very important to a personalized approach to the diagnosis and treatment of the condition in each patient.

Although a common disease, CRS is not by itself contagious. However, if there is a bacterial, viral or fungal infection, the micro-organisms can be transferred from one person to another.

If you think you may have chronic rhinosinusitis, it is important to see a physician as soon as possible because neglected CRS can lead to health complications including brain diseases.

Sources:

• Hopkins C, Surda P, Bast F, Hettige R, Walker A, Hellings PW. Prevention of chronic rhinosinusitis. Rhinology journal. 2018 Sept;0(0). doi:10.4193/rhin17.027. Available from: https://www.rhinologyjournal.com/Rhinology_issues/manuscript_1825.pdf

• Cho SH, Ledford D, Lockey RF. Medical Management Strategies in acute and chronic rhinosinusitis. The Journal of Allergy and Clinical Immunology: In Practice. 2020 May;8(5):1559–64. doi:10.1016/j.jaip.2020.02.020 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700823/

• Kwon E, O'Rourke MC. Chronic Sinusitis. StatPearls; [Internet. 2023 Aug.] Accessed March 18, 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441934/

• Buchheit KM. Patient education: Chronic rhinosinusitis (Beyond the Basics). [Internet, 2023 Oct.]. Cited 2024 Mar 19. Available from: https://www.uptodate.com/contents/chronic-rhinosinusitis-beyond-the-basics#H3

Related: Causes and Symptoms of Chronic Sinusitis Explained for Africans

Published: April 1, 2024

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