Common Nasal Conditions
In this booklet we will discuss:
- Rhinosinusitis
- Allergic rhinitis
- Sinusitis
Rhinosinusitis
“Rhino” is the latin word for nose. A “sinus” is a cavity within bone. In this booklet, the sinus or sinuses refer to the cavities in the bone surrounding the nose. These sinuses produce mucus and feed into the nose and throat. Ending words with “itis” indicates that there is inflammation involved. Using our definitions above, we can see that rhinosinusitis can be understood as inflammation of the nose and nasal cavities.
Rhinosinusitis is a common condition of the nose that is characterised by inflammation of the lining of the inner nose and inflammation of the sinuses next to the nasal cavity (the paranasal sinuses).
Symptoms:
Rhinosinusitis is characterised by the following symptoms:
- Nasal blockage due to obstruction or congestion
- Nasal discharge
- A cough in children
- Facial pain when pressure is applied
- A reduction or a loss of smell
Types of Rhinosinusitis
If the symptoms last for more than 10 days and less than 12 weeks (3 months), this is referred to as acute rhinosinusitis. Acute rhinosinusitis can be further divided into two main causes:
- Common cold/acute rhinosinusitis
Acute rhinosinusitis is caused mostly by viral infections such as the rhinovirus and influenza virus. This results in the inflammation of the areas of the nose mentioned above giving rise to the symptoms.
The symptoms last less than 10 days. Acute rhinosinusitis is self-limiting, meaning it resolves on its own without treatment. It is important to blow your nose to decrease the contaminated fluid from entering your sinuses.
- Acute post-viral rhinosinusitis (also known as subacute rhinosinusitis)
This is when the symptoms last more than 10 days but less than 12 weeks. It is also considered self-limiting.
Management
Since acute rhinosinusitis is self-limiting, management is aimed at symptom management to improve quality of life during the illness. Depending on the symptoms, symptoms severity and your healthcare provider, management may involve:
- Medications for pain and fever such as paracetamol (eg. Panado)
- Symptom relief with saline irrigation
- Nasal decongestants
- Steam inhalation
Acute bacterial rhinosinusitis
Acute bacterial rhinosinusitis is commonly caused by bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae. Bacterial rhinosinusitis is almost always an infection following rhinosinusitis caused by viral rhinosinusitis. The symptoms normally develop after 7 days of the viral causes of rhinosinusitis and bacterial infection is suggested by the following symptoms:
- A discoloured ‘yellow/green’ nasal discharge
- Severe pain on one side of the face
- Fever
- Symptoms developing after a week of initial symptoms
Treatment
Antibiotics would be prescribed for the treatment of a bacterial rhinosinusitis. Please note, antibiotics are only used for suspected bacterial infections as evidenced by the above-mentioned symptoms.
In addition to antibiotics, the treatment also involves the same measures as with acute viral rhinosinusitis.
Allergic rhinitis/hay fever
Allergic rhinitis is caused by an allergic response in the nose to airborne allergens inhaled in the nose. Most common allergens include:
- Pollen
- Dust
- Certain animals
The tendency to develop an allergic response to these allergens has a genetic component. You can learn more about how an inflammatory response develops to an allergy in our asthma booklet.
Symptoms
- Sneezing
- Itching
- Nasal congestion
- Conjunctivitis (‘pink eye’)
- Tearing
- Swelling
- Increased pressure in the ear
- Nasal discharge
Other symptoms include fatigue and drowsiness.
Complications
- Middle ear problems resulting in discharge or reduced hearing
- Acute and chronic sinusitis
Treatment
Treatment involves three major categories:
- Avoiding and preventing exposure to allergens
- Antihistamines to prevent or reduce severity of inflammation once exposed and to control symptoms
- Nasal decongestants
Chronic rhinosinusitis/ sinusitis
Chronic sinusitis is inflammation occurring in the sinuses for 12 weeks or longer. It is mostly preceded by allergic rhinitis.
Symptoms
- Nasal obstruction
- Nasal discharge
- Decreased sense of smell
- Cough
- Postnasal drip (mucus that runs down the back of your nose down your throat)
Management
Treatment involves intranasal corticosteroids (anti-inflammatory) and antibiotics. Chronic sinusitis can also be treated surgically if symptoms do not improve with medical treatment.
