What is the method for examining sinusitis?

Written by Deng Bang Yu
Otolaryngology
Updated on September 21, 2024
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Sinusitis refers to the inflammation that occurs in the mucous membrane or cavity of the sinuses. Clinically, the examination of sinusitis includes two aspects: one is the clinical examination, such as anterior rhinoscopy to inspect the nasal cavity, nasal endoscopy to inspect the nasal cavity, the opening of the sinuses, and the nasal passages; on the other hand, some imaging examinations can also be used, such as sinus CT examination, which is very important, and if necessary, sinus MRI can also be performed; there are also some other examination methods, such as nasal resistance examination, examination of sinus and nasal secretions, etc. Therefore, there are quite a few examination methods, among all the examination methods, the most important are the nasal endoscopy and sinus CT examination.

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Treatment of Chronic Rhinitis and Sinusitis

Chronic rhinitis and chronic sinusitis are due to persistent inflammation following acute inflammatory stimuli or recurrent attacks, leading to nasal and systemic symptoms. Patients may experience facial swelling and pain, headaches, and nasal congestion, generally bilateral and progressively worsening. Additionally, there may be yellow purulent discharge from the nasal cavity, sometimes accompanied by an odor. The examination can reveal congested and edematous bilateral nasal turbinates and abnormal secretions in the nasal cavity. For treatment, patients initially need a sinus CT scan; if sinusitis is confirmed, symptomatic anti-inflammatory treatment is necessary, including oral antibiotics, such as cephalosporins, which are relatively effective. Saline nasal irrigation is also required. If conservative treatment fails, the patient may need endoscopic sinus surgery and partial resection of the bilateral inferior turbinates to recover.

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How to treat sinusitis?

The treatment of sinusitis is mainly divided into two major categories. The first category is conservative treatment, and the second category is surgical treatment. Most patients consider conservative treatment because it can effectively control the condition and alleviate inflammation, and the overall effect is relatively good. In terms of medication, oral medications are primarily considered, commonly involving the use of antibiotics combined with nasal sprays and traditional Chinese medicine treatments. Additionally, physiological saline or seawater can be considered for nasal irrigation. Generally, the treatment period is about one to two weeks or more, and regular follow-ups are required. If it is fungal sinusitis, or if the effect of drug treatment for chronic sinusitis is not satisfactory, surgery may be considered. The surgery mainly involves minimally invasive sinus surgery under nasal endoscopy, which generally causes less damage and is quite effective.

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Written by Deng Bang Yu
Otolaryngology
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Does sinusitis require surgery?

Sinusitis refers to inflammation of the sinus, clinically mainly bacterial inflammation, as well as fungal inflammation. Whether sinusitis requires surgery depends on the specific condition of the patient. Endoscopic examination of the nose and sinus CT scans can be carried out to assess the condition of the sinus lesions. If there is a lot of sinus secretion and the sinus cavity is congested, and there is polypoid changes in the overall nasal passage, surgical treatment may be considered. For the vast majority of sinusitis patients, the current viewpoint is that treatment is mainly through medication, and only a small part needs surgical treatment after assessment. Therefore, sinusitis does not necessarily require surgery. Start with medication treatment; if the effect is not good, or there are other concurrent issues, consider surgical treatment after assessment.

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Written by Deng Bang Yu
Otolaryngology
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Is sinusitis the same as rhinitis?

There are differences between rhinitis and sinusitis. Rhinitis is mainly the inflammation of the nasal mucosa, while sinusitis is the inflammation of the sinus cavity mucosa. The main clinical symptoms of rhinitis are nasal congestion and a runny nose. This runny nose is mostly mucous or watery, which is typically seen in allergic rhinitis. The runny nose in sinusitis, on the other hand, is often a thick yellow discharge caused by a bacterial infection, so there is a distinction between the two. Patients with sinusitis often have rhinitis, but those with rhinitis do not necessarily have sinusitis. Rhinitis is primarily treated with medications and rarely with surgery. For sinusitis, treatment also begins with medications; however, if the response to medical therapy is poor or the condition is severe, surgery is often considered. The likelihood of undergoing surgical intervention is generally higher for sinusitis than for rhinitis.

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How to check for sinusitis?

The examination for sinusitis is mainly divided into three major categories. The first category is visual inspection. The second is endoscopic examination, and the third is radiologic examination. Visual inspection mainly involves directly observing with the naked eye the mucosa inside the nasal cavity, the inferior turbinate, and assessing the presence of thick nasal mucus. For some patients, a basic diagnosis can be made through visual inspection alone. However, for other patients whose conditions are not very clear, it becomes necessary to use endoscopic examinations, such as nasal endoscopy or fiberoptic nasopharyngoscopy, to visually inspect the interior of the nasal cavity and the nasopharynx for any abnormalities. If the inflammation is severe and conservative medical treatment is ineffective, it may also be necessary to consider a CT scan of the sinuses to make a clearer and more accurate diagnosis.