Chronic Sinusitis

Beware making this Dx in patient with chronic nasal congestion
  • Allergic Rhinitis much more likely
Chronic mucopurulent nasal drainage is key symptom
  • Think “Allergic Rhinitis” if clear discharge & esp. sneezing
  • Facial pressure common with both diagnoses
Non-Contrast CT very sensitive
  • Negative CT rules out sinusitis
  • Positive CT lacks specificity
  • Nasal endoscopy by ENT may be useful
Treatment Difficult
  • Antibiotics alone have high failure rate
  • Include steroid nasal sprays, maybe Monteleukast (Singulair®), maybe systemic steroids

See posting Nasal Congestion.