Definition

Inflammation of nose and paranasal sinuses that persists for 12 or more weeks characterized by

2 or more of the following symptoms

•           Blockage of nose

•           Discharge: anterior/posterior

•           Facial pain/ pressure

•           Reduction or loss of smell

Plus either

Diagnostic Endoscopy signs of

•           Nasal Polyps

•           Mucopurulent discharge from middle meatus

•           Oedema /mucosal obstruction primarily in the middle meatus

And/ or

CT changes: Mucosal changes within OMC /sinuses

Etiology

•           Mechanical obstruction of nose (Deviated nasal septum, nasal polyps, - hypertrophied turbinates)

•           Focal infection: nasal infection, adenotonsillitis, dental infection, trauma

•           Mucociliary clearance abnormality like cystic fibrosis

•           Allergy

•           Immunodeficiency

•           Autonomic imbalance

•           Hormones: pregnancy, Oral contraceptive pills (OCP)

•           Granulomatous conditions of nose

•           Idiopathic

Lab diagnosis

•           Diagnostic nasal endoscopy (DNE)

•           Culture and sensitivity test of nasal discharge

Radiological examination

NCCTPNS

Management

A.    Non —pharmacological

•           Reduce viral exposures by improved personal hygiene.

•           Reduce    exposure    to    dust,    moulds,    cigarette    smoke;    and other environmental chemical irritants.

•           Smoking cessation

B.    Pharmacological

•           Amoxicillin plus clavulanic acid 625 mg BD in adults for 7 days

375mg in children BD for 7 days.

•           Steam inhalation and nasal saline irrigation.

•           Topical Steroid Therapy: mometasone, budesonide orfluticasone spray

C.     Surgical

•           Caldwell luc surgery.

•           Functional Endoscopic Sinus Surgery (FESS).