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What are paranasal sinuses (PNS)?

PNS are mucosal lined air filled cavities in the skull bones adjacent to the nasal cavity and also communicating with this cavity. There are paired and unpaired sinuses. The paired ones are Maxillary sinuses, Ethmoidal sinuses, Frontal sinuses. Spenoidal sinus is unpaired.

What is Sinusitis?

Sinusitis is the result of infection of these paranasal sinuses. There are two types of sinusitis – Acute and Chronic. Acute sinusitis is characterized by definite tenderness over the affected sinuses and profuse purulent nasal discharge. The triad of nasal congestion, facial discomfort and nasal discharge most frequently defines chronic sinusitis. Frequently, not all of the symptoms of chronic sinusitis are present.

How is sinusitis diagnosed?

The diagnosis of Acute sinusitis is fairly easy and a plain X-ray of the paranasal sinuses (PNS) usually confirms the diagnosis.

In contrast to the relative ease of diagnosing acute sinusitis, diagnosis of headache and facial pain associated with chronic sinus disease requires careful history and meticulous evaluation. General headlight examination of the nose and X-ray of the PNS may be normal. The severity of the head and facial pain is variable and pain may be absent. Accurate diagnosis of chronic sinus disease therefore requires a careful history, comprehensive nasal endoscopic examination, and CT scan of the sinus area. Comprehensive nasal endoscopy is performed using surface anaesthesia in the outpatient setting using 0-degree and 30-degree endoscopes. The entire nasal chambers, its recesses and the area behind the nasal cavity is examined in detail. When chronic sinus disease is suspected a CT scan of the Osteomeatal complex may be performed. The endoscopic findings are then correlated with the CT scan findings and further steps in the treatment of the condition contemplated.

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