Sinusitis and Rhinitis
Diagnosis of the stuffy nose and nasal discharge through endoscopy of the nasal cavities
Chronic stuffy nose may be caused by a significant deviation of the nasal septum. It is then usually unilateral and will be resolved by surgery (septoplasty). It may also be due to an isolated polyp (malignant or benign tumour), which must be surgically removed. The stuffy nose may finally be due to a chronic inflammation of the nasal mucous membrane, such as rhinitis, whether allergic or not, and polyposis, which is the presence of many polyps in the two nasal cavities (to be differentiated from the isolated polyp, previously mentioned). These latter cases are generally associated to a back discharge and a decrease or even the disappearance of the sense of smell.
Sinusitis is the infection of one or more sinuses of the face, which are cavities of the facial bones surrounding the orbital cavities (cavities containing fat, and muscles mobilising the eyes). Sinusitis can be isolated, affecting a single sinus or several sinuses. It can be acute or chronic.
Rhinitis and sinusitis can even coexist in the same person, hence the term "rhinosinusitis" because the sinuses communicate with the nasal cavities by small orifices.
The chronic nature of rhinosinusitis is established when the inflammation persists for at least 12 weeks without complete disappearance of the symptoms during this period.
The diagnosis of rhinosinusitis is first established by an experienced ENT physician, who will carry out a precise interrogation and an endoscopy of the nasal cavities with an optical fibre. This examination makes it possible to assess the state of the nasal mucosa, and the presence of polyps, scabs and secretions at the level of the sinus orifices.
At the end of this consultation, the ENT doctor will prescribe a medical treatment and, according to its first endoscopy or according to the result of this treatment, a scanning of the nose and sinuses, which shows the inside of the nasal cavities and the internal anatomical architecture before a possible surgery (see chapter on sinus surgery).
Dr. Stéphane Hervé is an ENT specialist and a head and neck surgeon, who graduated from some of the best universities in France. He combines solid experience and training of more than 20 years, acquired in renowned hospitals and clinics equipped with advanced technology for the diagnosis of rhinosinusitis (endoscopes, nasal fiberscopes).