Aetiology, diagnosis and treatment of chronic rhinosinusitis: a study in a teaching hospital in Telangana

Abstract

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is one of the common problems in ENT Department which can be caused due to infections or anatomical blockage or allergy. We performed this study to assess the cause, clinical features and the effect of treatment on rhinosinusitis.</p><p class="abstract"><strong>Methods:</strong> 60 patients of chronic sinusitis with symptoms persisting beyond three months, Nasal Endoscopic findings with Polyps/Discharge/edematous mucosa were included in the study. A detailed clinical history, with complete Ear, Nose, Throat, and Head and Neck examination, blood tests like complete blood picture, Blood sugar levels, ESR and Hepatitis profile. X ray of paranasal sinuses, (water’s view) and lateral view, Chest x-ray –PA View and CT scan of paranasal sinuses (axial and coronal section with 3mm cuts at OMC) was done for all patients. Diagnostic Nasal Endoscopic examination (DNE) for detection of polyps / discharge / edematous mucosa in middle meatus was also done for the patients where it was necessary. The patients were given medical or surgical treatment according to the symptom and followup was done for 3 months for all patients. </p><p class="abstract"><strong>Results:</strong> Over 75% of the patients had incidence of sinusitis in the age group of 16 – 45 years. The most common etiology was sinusitis caused by infections (26 – 44%) followed by anatomical obstruction (22 – 36%). Of the 22 anatomical obstruction the most common was Deviated nasal septum in 14 (62%) of the cases followed by 4 (19%) CB, 3 (15%) pradixical MT and 1 (4%) prominent aggernasi. The most common sign and symptom was headache and polypoidal changes observed in 36 patients each (60%), followed by nasal obstruction in 35 patients (50%). 12 (20%) of the patients were treated with polypectomy + FESS while 14 (23%) of them were treated with septoplasty + FESS. 34 (57%) were treated with only FESS.</p><strong>Conclusions:</strong> Chronic sinusitis doesnot affect a particular age or sex and is more common among patietns with an upper respiratory tract infection. CT scan of the paranasal sinuses is the most useful tool in diagnosing the disease and FESS is the treatment of choice.

Anatomical variation of frequency and intensity of symptoms in patients nose with chronic rhinosinusitis

“…Among 80 patients enrolled in our study, 65% were male and 35% were female. Similar results were reported in a study by Surapaneni et al (18). All 80 patients in our study had more than one cardinal symptom (Table 2).…”

Assessment of Sinonasal Anatomical Variants using 128-Slice MDCT in Patients with Chronic Rhinosinusitis

“…In our study, males were more commonly affected with chronic rhinosinusitis accounting for 58% and females accounted for 42%. This is similar to the study conducted by Surapaneni H et al 20 which had reported the incidence of male candidates affected to be 60% and females 40%. Most of the previous studies performed by vinodhini P 21 , Dua et al 22 , Iseh et al 23 , Gibelli D et al 1 , had showed male preponderance with 66%, 57.5%, 52% and 63% respectively.…”

“…7 In our study, we have observed about 31% of the total cases affected with chronic rhinosinusitis were in the age range of 20-30 years. Surapaneni H et al 20 in the year 2016 conducted a study to determine the underlying cause, clinical features and the impact of treatment on chronic rhinosinusitis patients and had observed that 41.7% of patients with chronic rhinosinusitis fell in the age group 16 -30 yrs similar to our study. Another study conducted by Gibelli D 1 et al reported that the affected age group of chronic rhinosinusitis were in the age range of 21 -40 years accounting for 65.3% of their study population.…”

“…Most of the previous studies performed by vinodhini P 21 , Dua et al 22 , Iseh et al 23 , Gibelli D et al 1 , had showed male preponderance with 66%, 57.5%, 52% and 63% respectively. Surapaneni H et al 20 had demonstrated that the age or gender does not play any significance for causing chronic rhinosinusitis especially with upper respiratory tract infection. Moreover, the paper had concluded that CT scans to be valuable tool in diagnosing the disease.…”

Effect of living environment on ear, nose and throat diseases: a cross sectional survey in rural areas of Rohtas district in Bihar

“…It is also closely related to asthma as 10-40% of people with rhinitis have concomitant asthma, According to WHO, the prevalence of allergic rhinitis ranges between 10% to 32% in Asia, very similar to our study. 11 Chronic rhinosinusitis is one the common problems encountered in ENT department. It does not affect a particular age or sex and is more common among patients with an upper respiratory tract infection.…”