Chronic sinusitis without nasal polyps

Last reviewed: 1 Jun 2022
Last updated: 15 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • facial pain/pressure
  • nasal obstruction
  • nasal discharge/postnasal drip
  • purulence
  • headache
More key diagnostic factors

Other diagnostic factors

  • fatigue
  • cough
  • hyposmia/anosmia
  • fever
  • halitosis
  • dental pain
  • ear pain/pressure
Other diagnostic factors

Risk factors

  • ciliary dysfunction
  • aspirin sensitivity
  • allergic rhinitis
  • airway hyperreactivity/asthma
  • previous sinus surgery
  • immunodeficiency
  • severe mid-septal deviations
  • concha bullosa deformity
  • paradoxically bent middle turbinates
  • foreign bodies
  • craniofacial anomalies
  • smoking
  • sarcoidosis
  • granulomatosis with polyangiitis
  • history of asthma
More risk factors

Diagnostic investigations

1st investigations to order

  • anterior rhinoscopy
  • nasal endoscopy
More 1st investigations to order

Investigations to consider

  • sinus CT
  • sinus MRI
  • nasal/sinus cultures
  • allergy testing
More investigations to consider

Treatment algorithm

ACUTE

chronic sinusitis

ONGOING

patients with continued symptoms despite medical therapy

Contributors

Authors

Raj Sindwani, MD, FACS, FRCS

Section Head of Rhinology, Sinus, and Skull Base Surgery

Head and Neck Institute

Cleveland Clinic Foundation

Cleveland

OH

Disclosures

RS is an author of a number of references cited in this topic.

Christopher Roxbury, MD

Assistant Professor

Rhinology and Endoscopic Skull Base Surgery

Section of Otolaryngology - Head and Neck Surgery

Department of Surgery

University of Chicago Medicine & Biological Sciences

Chicago

IL

Disclosures

CR declares that he has no competing interests.

Acknowledgements

Dr R Sindwani and Dr C Roxbury would like to acknowledge Dr J Antisdel, a previous contributor to this topic.

Peer reviewers

Ryland P. Byrd, Jr, MD

Professor

James H. Quillen College of Medicine

East Tennessee State University

Johnson City

TN

Disclosures

RPB declares that he has no competing interests.

Thomas Sanford, MD

Assistant Professor of Otolaryngology - Head and Neck Surgery

St Louis University School of Medicine

St Louis

MO

Disclosures

TS declares that he has no competing interests.

Ozgur Yigit, MD

Chief

ENT Department

Istanbul Training and Research Hospital

Istanbul

Turkey

Disclosures

OY declares that he has no competing interests.

Christos Georgalas, MD, PhD, DLO, FRCS (ORL-HNS)

Assistant Professor/Consultant

Academic Medical Center

Amsterdam

The Netherlands

Disclosures

CG declares that he has no competing interests.

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