Practice

10-minute consultation: sinusitis

BMJ 2007; 334 doi: 10.1136/bmj.39161.557211.47 (Published 31 May 2007)
Cite this as: BMJ 2007;334:1165

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  1. Neil K Chadha, specialist registrar in otolaryngology1,
  2. Rashmi Chadha, general practitioner2
  1. 1ENT Department, Torbay Hospital, Torquay TQ2 7AA
  2. 2Ivybridge Health Centre, Ivybridge, Devon PL21 0AJ
  1. Correspondence to: N K Chadha neil_chadha{at}hotmail.com
  • Accepted 12 September 2006

A 39 year old woman attends your surgery with a four day history of unpleasant yellowish nasal discharge, blocked nose, and severe pain across her cheeks and between her eyes. One week ago she had had a “bad cold” and she thought she was getting better, but then this started.

What issues you should cover

Sinusitis, now termed rhinosinusitis, is inflammation of one or more of the paranasal sinuses. It is clinically defined by at least two of the following symptoms: blockage or congestion; discharge or postnasal drip; facial pain or pressure; reduction or loss of smell. In acute rhinosinusitis symptoms persist for up to 12 weeks, with complete resolution; in chronic rhinosinusitis symptoms persist for more than 12 weeks without complete resolution. Viruses (coryza, rhinovirus, or influenza, for example) cause mucosal swelling and …

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