Aetiology, diagnosis and treatment of chronic rhinosinusitis: a study in a teaching hospital in Telangana
Keywords:Chronic rhino sinusitis, Etiology, Polyps, Nasal discharge
Background: Chronic rhinosinusitis is one of the common problems in ENT Department which can be caused due to infections or anatomical blockage or allergy. We performed this study to assess the cause, clinical features and the effect of treatment on rhinosinusitis.
Methods: 60 patients of chronic sinusitis with symptoms persisting beyond three months, Nasal Endoscopic findings with Polyps/Discharge/edematous mucosa were included in the study. A detailed clinical history, with complete Ear, Nose, Throat, and Head and Neck examination, blood tests like complete blood picture, Blood sugar levels, ESR and Hepatitis profile. X ray of paranasal sinuses, (water’s view) and lateral view, Chest x-ray –PA View and CT scan of paranasal sinuses (axial and coronal section with 3mm cuts at OMC) was done for all patients. Diagnostic Nasal Endoscopic examination (DNE) for detection of polyps / discharge / edematous mucosa in middle meatus was also done for the patients where it was necessary. The patients were given medical or surgical treatment according to the symptom and followup was done for 3 months for all patients.
Results: Over 75% of the patients had incidence of sinusitis in the age group of 16 – 45 years. The most common etiology was sinusitis caused by infections (26 – 44%) followed by anatomical obstruction (22 – 36%). Of the 22 anatomical obstruction the most common was Deviated nasal septum in 14 (62%) of the cases followed by 4 (19%) CB, 3 (15%) pradixical MT and 1 (4%) prominent aggernasi. The most common sign and symptom was headache and polypoidal changes observed in 36 patients each (60%), followed by nasal obstruction in 35 patients (50%). 12 (20%) of the patients were treated with polypectomy + FESS while 14 (23%) of them were treated with septoplasty + FESS. 34 (57%) were treated with only FESS.Conclusions: Chronic sinusitis doesnot affect a particular age or sex and is more common among patietns with an upper respiratory tract infection. CT scan of the paranasal sinuses is the most useful tool in diagnosing the disease and FESS is the treatment of choice.
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