Sinusitis and nasal polyps

What is sinusitis?

Sinusitis is a common complaint and causes a blocked nose, nasal discharge and sometimes loss of sense of smell or pain – some patients describe it as like having a constant cold. It is due to inflammation of the sinuses, which are air spaces in the cheeks, between the eyes and in the forehead. The correct term is rhinosinusitis because the nasal lining also becomes inflamed in this situation.

What causes sinusitis?

There is no single answer and there are likely to be many factors which contribute to chronic rhinosinusitis which are different in different people. They include things such as the structure of the nose and sinuses, the function of the sinus lining, bacteria, viruses and fungi, problems with the immune system and genetics. In some people, particularly with nasal polyps, the problem is essentially the same as asthma and it is not unusual to have both asthma and sinusitis.

How do we investigate it?

In the clinic we take a careful history and examine the nose, usually with a small endoscope and camera. Generally, if we suspect sinusitis, a CT scan will be recommended.

How is it treated?

Medications are generally used first – and in many patients, this is all that is needed. However, when medications don’t provide long term relief, sinus surgery may be recommended. The aim of the surgery depends on the nature of the sinus disease. In many cases surgery alone provides long term relief. However, in some patients, particularly with nasal polyps, the aim of surgery is to allow nasal medications to enter the sinuses using a medicated sinus wash in a similar way to using inhalers to manage asthma, and this may need to be continued long term.

What if I have had surgery before?

Ongoing problems after sinus surgery are generally due to problems with the surgery itself, scar formation in the sinuses afterwards, the nature of the sinusitis in that particular patient, or problems with postop sinus care. Dr Timperley has undergone advanced training in modern surgical and medical treatment of sinusitis and postoperative care is emphasised to ensure the best possible result is achieved. Those who have had surgery in the past will be relieved to know that gauze nasal packing is no longer used!