Introduction
Chronic Rhinosinusitis (commonly known as CRS) is a chronic inflammatory respiratory condition that affects nearly 28.9 million (11.6% of the general population) worldwide. The body's inability to remove mucus from the sinuses results in symptoms including a stuffy nose and facial and nasal pain, which may persist for 12 weeks or more and drastically lower the patient's quality of life. The number of people with CRS has increased recently, attributed to limited research and prevalence as a comorbid condition (two or more conditions occurring at the same time) with other conditions such as asthma, allergies.
How does CRS affect the body?
Sinuses are hollow spaces behind the eyes, nasal bones, cheeks and forehead. They are responsible for humidifying, circulating air through the nasal passage and secreting mucus to protect against foreign particles. Swelling and inflammation of the mucus lining in the sinuses due to polyps (growth) or infection (viral, fungal or bacterial) causes CRS.
Researchers have identified two major categories of CRS:
• Chronic rhinosinusitis without nasal polyposis: This is the most prevalent kind of rhinosinusitis. The swelling and irritation of the sinus lining in this type of rhinosinusitis can be brought on by a variety of things, including allergies or infections.
• Chronic rhinosinusitis with Nasal polyps: Individuals with this condition develop "nasal polyps" which are abnormal growths of tissue inside their sinuses or nostrils. The polyps may enlarge and proliferate to the point where they block the nasal passages and sinuses.
Symptoms and diagnosis
Most times, CRS is overlooked or misdiagnosed because of its comorbid prevalence. Some symptoms that show the condition include:
Thick, discolored mucus from the nose, known as a runny nose.
Mucus down the back of the throat, known as postnasal drip.
Blocked or stuffy nose, known as congestion. This makes it hard to breathe through the nose.
Pain, tenderness and swelling around the eyes, cheeks, nose or forehead.
Reduced sense of smell and taste.
Other symptoms can include:
Ear pain.
Headache.
Aching in the teeth.
Cough.
Sore throat.
Bad breath.
Tiredness.
Chronic Rhinosinusitis can be diagnosed by a physical examination, where a doctor can assess the symptoms. More accurate diagnoses can be achieved through these measures:
Nasal endoscopy: This examination employs a thin instrument with a camera at the end to examine the sinuses. The instrument is known as an endoscope. To view the inside of the nose, the endoscope is inserted through the nostrils.
CT scan, or computed tomography: X-rays are used in this test to create pictures of the sinuses. Compared to standard X-ray exams, the images are more detailed.
Treatment of CRS
Chronic Rhinosinusitis is treatable through a variety of methods, including:
Topical Corticosteroids: Nasal sprays containing corticosteroids, such as fluticasone (Flonase), budesonide (Rhinocort), and mometasone (Nasonex) are effective in reducing inflammation and relieving symptoms. Many are available over the counter.
Nasal Irrigation: Rinsing the nasal passages with saline solution, either through a neti pot or a squeeze bottle can help clear the mucus and alleviate congestion.
Systemic Corticosteroids: In cases of severe sinusitis, particularly when accompanied by nasal polyps, oral or injectable corticosteroids may be prescribed. However, prolonged use can have significant side effects, requiring careful monitoring.
Allergy Management: If allergies are a contributing factor to sinusitis, appropriate allergy medications, such as antihistamines or decongestants, can help alleviate symptoms.
Aspirin Desensitization: For individuals experiencing sinusitis and nasal polyps triggered by aspirin sensitivity, a gradual increase in aspirin dosage under medical supervision can help them tolerate the medication.
Biologic Therapies: In cases of chronic sinusitis with nasal polyps, medications like dupilumab (Dupixent), omalizumab (Xolair), and mepolizumab (Nucala) may be administered to reduce the polyp size and improve nasal airflow.
Antibiotics: Bacterial sinusitis may require treatment with antibiotics, often in conjunction with other medications.
Immunotherapy: For allergy-related sinusitis, immunotherapy (allergy shots) can help reduce symptoms.
Surgery: In cases of chronic sinusitis unresponsive to medical management, endoscopic sinus surgery may be considered. This minimally invasive procedure involves using specialized tools to remove the affected tissue.
Sources
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Image:“Illustration depicting chronic sinusitis: a close-up of a face with inflamed sinuses highlighted, a doctor examining with a magnifying glass, a person using nasal spray, another person sneezing near tissues, and various treatments like pills and a thermometer in the background.” (n.d.). What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)? Retrieved from https://allergyasthmanetwork.org/health-a-z/chronic-rhinosinusitis-with-nasal-polyps-crswnp/.