How is Chronic Sinusitis Diagnosed and Treated? - " Bill a 50-year-old male"

Case study ( 20887 views as of May 23, 2024 )

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.


Conversation based on: How is Chronic Sinusitis Diagnosed and Treated? - " Bill a 50-year-old male"

How is Chronic Sinusitis Diagnosed and Treated? - " Bill a 50-year-old male"

  • I might worth getting a CT Scan to see.what is going on with your Sinus
  • Certainly my sinus issue become greater as the spring and fall season hit full steam.
    • The treatment for sinusitis depends on which type of sinusitis it is. It could be viral, in that case the treatment is purely symptomatic, which consist of decongestants and nasal flushes; whereas if it's bacterial, the treatment consists of antibiotics.
  • I have been suffering with chronic sinusitis and have recently discovered that I am allergic to a number of environmental things - including dust mites and grass pollens. Both of these things are virtually impossible to avoid. I believe that my sinusitis has been largely allergy driven without knowing it. I have therefor recently started allergy shots to see if I can prevent my chronic sinusitis.
    • @Chantal - were allergy shots the first recommendation for you to try and reduce your chronic sinusitis symptoms? I ask because I know that surgery is also a treatment options for some people who suffer from persistent and chronic sinusitis, and I wonder when surgery is brought in as a treatment option.
  • That's really interesting. It makes sense that keeping the body in balance with acupuncture and other treatments could be an ongoing process, in varying degrees, as ones environment is always changing on some level.
    • Sleep apnea can have a severe effect on your daily functioning as well as your overall health. There are various treatments available for snoring ranging from nasal strips to dental devices all the way through to laser surgery of the palate.
    • I think the Diagnosis and Treatment of Chronic Sinusitis is definitely related to allergies and the changing of the seasons. I also think once you have had chronic sinusitis once you are more likely to it again.
  • Sinusitis definitely affects my sense of smell.
    • @Joy Taste and Smell are completely related, so I would think yes, sinusitis could be affecting taste as well.
    • It affects my sense of smell and taste. Is that possible?
  • At what point do you want to see an ENT to check for polyps - does anyone know? I have had bad sinuses for quite awhile but have not tried some of these more holistic approaches.
    • I was sent for a referral to an ENT when my condition kept returning and was showing signs of resistance to treatment.
  • Try using a Netti Pot along with other recommended treatments. Once you get the hang of it, it's quite effective to help with conjestion and sinus pain.
    • There are also saline cleansing systems for sinusitis that gently push the fluids into the passages. Some are squeeze bottles and others are pressurized bottles. Check with your local pharmacist about which option is best for you.
    • Are all Neti pots the same? Do they all work for sinusitis?
  • Acupuncturist have several acupuncture points to use to help with this condition. Having regular acupuncture treatments will open up the sinus pathways and resolve phlegm/discharge and calm the area tissues. Also, it is important for this person to feel stronger and well rested so we would also want to promote their immune system with some Cupping Therapy.
    • I wouldn't have thought of acupuncture to treat sinusitis. Thank you for the suggestion.
    • The number of Acupuncture Treatments for any condition varies with everyone. The constitution of the person, what types of environments they are living/working in, what types of things are they doing or not doing to help themselves and how long they have been dealing with the condition. Sometimes I have had clients that get a reprieve of their condition for most of the year until a season changes or the temperature outside changes, then we get them back on track. We are always working to assist the body to come back into balance.
    • Would you need ongoing acupuncture treatments to relieve chronic sinusitis symptoms? Do your clients find relief after one session?
    • Hi Julianne, how many acupuncture treatments does it typically take to help clear up chronic sinusitis? I had never thought of this type of treatment for sinus problems.
    • Thanks Julianne, I will try acupuncture next time my sinus's act up.
  • I used to get sinusitis for years but fortunately it stopped. I think it was back when people smoked in bars and restaurants, I know exposure to second hand smoke was a big trigger for my sinusitis.
  • What age group is more susceptible to Chronic Sinusitis ? Is there something that can be done to try and avoid it ?
    • And what symptoms should one look for to determine sinusitis? Are there specific measures used to determine Chronic sinusitis, vs other kinds?
  • Those with chronic sinusitis may find relief after pinpointing foods in their diet that tend to worsen sinus congestion. Sulfites anecdotally are one common culprit. A dietitian or nutritionist can help discuss common trigger foods and see if the elimination of these foods provides some relief.
    • @Joy - when my kids are stuffy I often suggest lowering milk consumption but never knew why. Now I can tell them it's because of "sinusitis" :)
    • I believe milk is a trigger as well.
    • I notice immediately when I eat something that effects my sinuses. My nose get stuffy and runny right away. Diet and a dust free environment are key!
    • It's a common complaint that wine tends to make sinusitis worse. Both red and white wine contain sulfites.
    • Red wine contains sulfites, doesn't it? I often feel "sinusy" after a glass of wine. It definitely bothers my sinuses so I tend to avoid it now.
    • That is very interesting Sarah. I have a hard time avoiding my triggers, grass, dust etc. But I make sure to take allergy medication regularly.
  • My friend had nasal polyp removal surgery and she was told it may return in future. However, surgery provided relief for her.
    • @carrle, will you do another course of steroid treatment or is the next step polyp removal?
    • I have had chronic sinusitis for years as well, I had a GP continually put me on antibiotics when I finally asked for a referral to an ENT. I had polyps, but he didn't want to do surgery right away. Instead he gave me steroid injections regularly for 6 months and it made a huge difference for me. Has anyone heard of this type of treatment before.
    • This is what happened with my friend. In the 10 years I have known her she has had the polyps removed three times.
  • A good friend of mine has nasal polyps and has had no sense of smell for years. She was never diagnosed with sinusitis though. Are there more than one cause of nasal polyps ?
    • From my understanding, nasal polyps can lead to chronic sinusitis but not the other way around. Nasal polyps are not always the cause of sinusitis either, though are commonly associated. Polyps themselves may be more likely to develop in those with asthma or infections that irritate the nasal lining.
  • I Have chronic Sinusitis for years and am glad to know there are treatment options.
    • Further to my earlier comment How is Chronic Sinusitis Diagnosed and Treated? is that it would be beneficial to get a CT Scan
    • I too suffer from sinusitis. It has been found that my nasal passages are curved. This contributes to post nasal drip, sore throat, trouble breathing, sleep apnea. Our sinuses have a large effect on our whole body.
    • I am too a life long sufferer of chronic sinusitis. This website has given me a lot of great information to go with.
    • I am the same, and wonder if my chronic sinusitis will result in the need for surgical treatment at some point. I have seen some relief in regular sinus cleaning.
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