Sinus, aka Rhinitis and/or Sinusitis

  There is a lot of confusion and misconceptions with their generalized use of the word “sinus”. Symptoms ranging from a blocked nose, itching, sneezing and a postnasal discharge (“sinus drip”) to headaches, pain in the face and even a sore throat, swallowing disorders and nose bleeds will all be blamed on “sinus”.   The nose is nothing more than an air conditioner for the lungs. It has a self-regulatory mechanism which controls the amount of swelling and the amount of mucus secretion to achieve heating and humidification of the air we breathe in. Whenever these control mechanisms go wrong, we get symptoms which are erroneously called “sinus”.   The better and more specific term for this condition is “rhinitis”. Rhinitis can be caused by allergies, environmental factors like pollution, cigarette smoke, temperature and humidity, as well as infections from viruses and bacteria. Typical symptoms would be one or more of a blocked nose, a runny nose, itching, sneezing, a postnasal discharge or sometimes a very dry nose. Blockage of the nose can also lead to headaches and pain in the face. Rhinitis almost always requires medical treatment rather than surgery.   The sinuses or paranasal sinuses are air filled cavities inside the facial bones of the skull. They all have small openings connecting them to the nasal cavity. When the sinuses become infected (e.g.  following a flu), we call it sinusitis. Narrow sinus openings can cause such an infection to become an ongoing or chronic sinusitis. Similar to rhinitis, it can cause symptoms like a blocked and runny nose and a postnasal discharge. It may also be associated with pain in the face, a thick yellowish discharge from the nose, sore throat, hoarseness and coughing. Acute sinusitis may be treatable with antibiotics, but chronic sinusitis usually requires an operation which is called a FESS (functional endoscopic sinus surgery). The aim of this operation is to widen the obstructed sinus openings. This operation, when done delicately and correctly, gives excellent long term results.   It is very difficult to distinguish between rhinitis and sinusitis because of the overlap of symptoms. A CT scan of the sinuses is usually required to make the final diagnosis. A CT scan not only provides the correct diagnosis, but also reveals anatomical abnormalities like narrow sinus openings which may require a FESS.   (To read more about these conditions, you can follow these links: https://entdoctoreras.co.za/sinus/ and https://entdoctoreras.co.za/sinusitis/ )