Chronic rhinosinusitis

Abstract

Chronic rhinosinusitis affects 10.9% of the UK adult population, affecting quality of life and with significant economic cost. The aetiology is unknown, and diagnosis can present challenges. It is characterised by inflammation of the nose and paranasal sinuses that leads to nasal obstruction, discharge, facial pain or pressure and loss of smell, persisting for more than 3 months. Nasal cavity examination aids diagnosis. It is subdivided into chronic rhinosinusitis with and without nasal polyposis. Nasal corticosteroids and saline irrigation make up current baseline management in primary care, with referral to ENT recommended for those with persistent symptoms. Physicians should be alert to persistent unilateral symptoms and the risk of sino-nasal tumours.