Chronic sinusitis
Updates to Article Attributes
Chronic sinusitis refers to ongoing long term sinus infection-inflammation that often develops secondary to a prolonged/refractory acute sinus infection.
Epidemiology
It most commonly affects young to middle-aged adults but can uncommonly affect children.
Pathology
Aetiology
- deviated nasal septum
- sinonasal polyposis
- sinus anatomy distortion that may be congenital or from prior trauma
- allergic reactions
Radiographic features
CT
A characteristic feature on CT sinuses is sclerotic thickened bone involving the sinus wall from a prolonged mucoperiosteal reaction. Intrasinus calcification may be present. The presence of opacification is not a good distinguisher from an acute sinus infection.
See alsoTreatment and prognosis
sinonasal diseaseA study was done on 150 patients of chronic rhinosinusitis
-
sinusitis- concha bullosa (30%)
-
chronic sinusitis allergic fungal sinusitisuncinate process variations (25%)- paradoxical middle turbinate (10%)
- agger nasi cells (10%)
- Haller cells (9%)
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Functional endoscopic sinus surgery (FESS) has revolutionized the approach and treatment of chronic rhinosinusitis. Certain anatomical variations are thought to be predisposing factors for the development of sinus disease and it is necessary for the surgeon to be aware of these variations, especially if the patient is a candidate for FESS 10.
-</ul><h4>Radiographic features</h4><h5>CT</h5><p>A characteristic feature on CT sinuses is sclerotic thickened bone involving the sinus wall from a prolonged mucoperiosteal reaction. <a title="Intrasinus calcification" href="/articles/intrasinus-calcification">Intrasinus calcification</a> may be present. The presence of opacification is not a good distinguisher from an acute sinus infection.</p><h4>See also</h4><ul><li>-<a href="/articles/sinonasal-disease">sinonasal disease</a><ul><li>-<a href="/articles/sinusitis">sinusitis</a><ul>-<li><a href="/articles/acute-sinusitis">acute sinusitis</a></li>-<li><strong>chronic sinusitis</strong></li>-<li><a href="/articles/allergic-fungal-sinusitis">allergic fungal sinusitis</a></li>-</ul>-</li></ul>-</li></ul>- +</ul><h4>Radiographic features</h4><h5>CT</h5><p>A characteristic feature on CT sinuses is sclerotic thickened bone involving the sinus wall from a prolonged mucoperiosteal reaction. <a href="/articles/intrasinus-calcification">Intrasinus calcification</a> may be present. The presence of opacification is not a good distinguisher from an acute sinus infection.</p><h4>Treatment and prognosis</h4><p>A study was done on 150 patients of <a href="/articles/chronic-sinusitis">chronic rhinosinusitis</a> and found the following anatomical variants <sup>10</sup>:</p><ul>
- +<li>
- +<a href="/articles/concha-bullosa">concha bullosa</a> (30%)</li>
- +<li>posterior septal deviations (25%)</li>
- +<li>uncinate process variations (25%)</li>
- +<li>paradoxical middle turbinate (10%)</li>
- +<li>
- +<a href="/articles/agger-nasi-cells">agger nasi cells</a> (10%)</li>
- +<li>
- +<a href="/articles/haller-cells">Haller cells</a> (9%)</li>
- +</ul><p><a href="/articles/functional-endoscopic-sinus-surgery-1">Functional endoscopic sinus surgery (FESS)</a> has revolutionized the approach and treatment of chronic rhinosinusitis. Certain anatomical variations are thought to be predisposing factors for the development of sinus disease and it is necessary for the surgeon to be aware of these variations, especially if the patient is a candidate for FESS <sup>10</sup>.</p>
References changed:
- 10. Wani AA, Kanotra S, Lateef M et-al. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg. 2009;61 (3): 163-8. <a href="http://dx.doi.org/10.1007/s12070-009-0059-8">doi:10.1007/s12070-009-0059-8</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449989">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/23120628">Pubmed citation</a><span class="auto"></span>
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