Generally defined as an inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer

Aetiology

Predisposing factors include:

• Atopy: hay fever, asthma
• Nasal obstruction e.g. Septal deviation or nasal polyps
• Recent local infection e.g. Rhinitis or dental extraction
• Swimming/diving
• Smoking

Clinical presentation

• Facial pain: typically frontal pressure pain which is worse on bending forward
• Nasal discharge: usually clear if allergic or vasomotor
  • Thicker, purulent discharge suggests secondary infection
• Nasal obstruction: e.g. 'mouth breathing'
• Post-nasal drip: may produce chronic cough

Red flag symptoms

• Unilateral symptoms
• Persistent symptoms despite compliance with 3 months of treatment
• Epistaxis

Management

• Avoid allergen
• Intranasal corticosteroids