CONDITIONS
Acute & Chronic Rhinosinusitis

Rhinosinusitis occurs when the nasal cavity and paranasal sinuses become inflamed. Rhinosinusitis presents symptoms of sinusitis in conjunction with rhinitis and therefore causes congestion or, otherwise, a runny nose resulting in fluid draining from the back or front of the nose. Symptoms of rhinosinusitis also lead to facial pain and a complete (anosmia) or partial (hyposmia) loss of smell.
Symptoms
Signs of acute and chronic rhinosinusitis include:
- Congested nose
- Yellow or green mucosal discharge
- Headache
- Facial pain and pressure around the eyes, nose and forehead
- Eye swelling
- Mucous flowing at the back of the throat (postnasal drip)
Associated causes
Bacteria, usually streptococcus, affect the sinuses and lining of the nasal cavity, leading to infection. Viruses also account for infection, causing acute rhinosinusitis. Allergies to food, certain environmental factors and fungi may also result in chronic rhinosinusitis.
When to seek treatment
When symptoms of rhinosinusitis do not improve after seven days and begin to progress, even more, you need to consult with an ENT specialist. Should your condition worsen, your doctor may place you on antibiotic therapy.
Treatment for acute and chronic rhinosinusitis
By conducting a physical exam, Dr Cezula can check for nasal polyps, a mucous blockage in the meatus, otherwise known as the middle orifice and mucopurulent discharge (emission of mucous together with pus).
Rhinosinusitis is categorised according to its duration. Acute rhinosinusitis lasts for 2-4 weeks with complete resolution of symptoms. Subacute rhinosinusitis lasts for 4-12 weeks and can progress to chronic rhinosinusitis, which lasts more than 12 weeks.
One of the complications of chronic rhinosinusitis is the growth of nasal polyps in the nasal cavity and paranasal sinuses. The formation of these small growths is a result of the recurrence of the inflamed nasal mucosa that can alter the anatomical appearance of the paranasal sinuses or nasal cavity. These nasal polyps may increase in size, causing breathing complications and affecting your taste and sense of smell.
Saline nasal sprays relieve dryness in the nose, therefore reducing sniffing. When medical management through the use of saline sprays and intranasal corticosteroids proves ineffective, Dr Cezula may perform endoscopic sinus surgery to relieve your symptoms.
FAQ
How do you perform endoscopic sinus surgery?
Dr Cezula inserts a thin tube (endoscope) with a lighting system to see your nasal cavity and sinuses through the opening of the nose. Next, she inserts surgical instruments to clear the sinuses of any obstruction, including nasal polyps or thickened tissue. Then, using a microdebrider, she removes any tissue covering the sinus opening.
Is rhinosinusitis dangerous?
Rhinosinusitis may be dangerous if it spreads to structures close to the sinuses like the brain and the eyes. It may also signify a more severe, underlying problem like a tumour growing in the nose and sinuses. You have to visit your ENT doctor when sinus pain and pressure persist for over a week and if it is associated with facial and eye swelling.
How soon can you begin exercising after endoscopic sinus surgery?
Generally, you can go back to normal light activity after endoscopic sinus surgery after 3 days. You must avoid strenuous exercise or putting further strain on your body by limiting physical activity for 1 week. Dr Cezula will alert you if there are other reasons for limiting exercise for longer than that period.