Case study ( 18968 views as of February 5, 2023 )
Bill, a 50-year-old male, presents with an eight year history of nasal congestion, anterior and posterior nasal discharge, a reduced sense of smell and is feeling generally fatigued. Despite these symptoms, Bill has managed to continue to function in his daily routine, however at a reduced level. He remembers exactly when this started after a bad cold and can almost give his doctor the exact date. He has been on several courses of antibiotics that only help him partially and only for a short time. The symptoms almost always return. He has also been put on prednisone for short bursts of 2-3 weeks, during which time he feels great. His sense of smell and energy return and he feels back to normal for a short time. Bill has also been told in the past year that he has developed asthma, which he never had before.
On endoscopic examination of his nasal passage, Bill's doctor discovers he has nasal polyps in both middle meatie (nasal passages), with coloured discharge going down the back of his throat. His doctor explains that this discovery, along with Bill's adult-onset asthma and his symptoms of sinusitis lasting more than three months clearly point to chronic sinusitis.
Patients like Bill typically do not get better on medical management and can potentially require endoscopic sinus surgery and careful post-operative care for successful management and cure of their chronic sinusitis symptoms.Author: Dr. Amin Javer