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Rhinosinusitis occurs when the lining of the sinuses gets infected or irritated, becomes swollen, and creates extra mucus. The swollen lining may also interfere with drainage of mucus. Chronic rhinosinusitis refers to a condition that lasts at least 12 weeks, despite being treated, and causes at least two of the following symptoms:
Chronic rhinosinusitis is different from the more common form of rhinosinusitis (called acute rhinosinusitis), which is a temporary infection of the sinuses that often occurs following colds. Chronic rhinosinusitis is a more persistent problem, which requires a specific treatment approach. It is sometimes overlooked by both patients and health care providers because the symptoms are more low-grade and chronic.
Inform patient of the natural course of chronic rhinosinusitis, and that it may last for several months, but does not usually require referral.
If the person has an associated disorder, such as allergic rhinitis, asthma, or dental infection advise them that good control of these is also likely to benefit their rhinosinusitis symptoms.
Advise the person to:
Consider nasal irrigation with saline solution to relieve congestion and nasal discharge.
Please see Prescribing section for further guidance.
Refer Red Flags immediately.
Generally referral from chronic rhinosinusitis is not required. Consider referrals to an ENT specialist if the patient has:
GHFT offers an ENT Advice and Guidance service via eRS. Specialist advice can be sought via this route as an alternative to referral.