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Long-lasting relief for chronic allergic sinusitis patient in her 20s

Abstract Chronic sinusitis is the infection of the paranasal sinuses that laster longer than 12 weeks. It can lead to swelling and inflammation of the sinuses, along with blockage of the airflow due to mucus production. It is one of the most common afflictions in adults in India, more prominent than even diabetes, coronary heart disease, and asthma.

FESS case report

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The case report details the case of a woman in her late 20s suffering from chronic sinusitis and her treatment journey.

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Abstract

Chronic sinusitis is the infection of the paranasal sinuses that laster longer than 12 weeks. It can lead to swelling and inflammation of the sinuses, along with blockage of the airflow due to mucus production. It is one of the most common afflictions in adults in India, more prominent than even diabetes, coronary heart disease, and asthma. The case report details the case of a woman in her late 20s suffering from chronic sinusitis and her treatment journey.

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Background

Chronic sinusitis usually occurs due to the formation of nasal polyps, allergies, and respiratory tract infections. They are also common in people with deviated nasal septums and immune system-related diseases such as cystic fibrosis, HIV, etc. 

One of the characteristic features of chronic sinusitis is that the patient is not receiving adequate or long-lasting relief from conservative treatments and needs surgical intervention. Since sinusitis is such a common disease in India, it is essential that patients learn the appropriate treatment for chronic sinusitis to avoid future complications like blindness, meningitis, etc.

Case Presentation

The patient is a woman in her late 20s who had been suffering from chronic sinusitis and related symptoms for almost 20 years. She had frequent bouts of common colds and sinus problems, along with sinus-related headaches. She had tried conservative treatments such as medicines, saltwater gargles, steam, etc., her whole life, but none of these had provided her adequate long-lasting relief. 

Finally, she approached Pristyn Care for treatment. Our ENT doctor performed a thorough physical examination, along with diagnostic tests such as tissue culture, blood tests, and CT scans. On diagnosis, it was revealed that she has been suffering from allergy-induced chronic sinusitis all this time. Additionally, the CT scans and X-ray images revealed that she has a deviated nasal septum which makes her more susceptible to sinus infections.

To ensure complete and long-lasting recovery, the ENT surgeon recommended a combined surgery, including septoplasty and FESS surgery. Her surgery was scheduled and performed within the following week. She experienced mild pain and discomfort for about 1 week after the surgery. But after one week, her airway cleared and she was able to breathe without issues for the first time in almost 20 years.

Investigation:

CT scan for the paranasal and nasal area, Endoscopy, Allergy Test, Nasal X-ray, Complete Blood Count, Tissue culture 

Differential diagnoses:

  • Influenza
  • Nasal Polyposis
  • Sarcoidosis
  • Acquired and congenital immunodeficiency, 
  • Allergic and nonallergic rhinitis, etc.

Treatment:

She received a combined septoplasty and FESS surgery to drain her sinuses and clear her airway.

Outcome & Follow-up:

She had a little pain and discomfort for a week after the surgery but recovered completely without any complications within 2-3 weeks. 

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Discussion:

Sinusitis is an incredibly common disorder and while conservative management remains to be the primary treatment in most cases, it is important that patients are educated enough about their condition to seek surgery when required.

FESS is an endoscopic surgery in which the surgeon inserts an endoscope and the surgical instruments into the sinuses through the nasal canal to avoid any cuts, sutures, or scars on the face. It has a success rate of around 80-90% and provides almost instantaneous relief even to patients with chronic problems.

Also read: Complete guide to FESS surgery

In addition to FESS, there are other surgical procedures such as balloon sinuplasty, image-guided surgery, etc. that the surgeon may perform to cure chronic sinusitis. The choice of treatment is generally made based on the patient’s age, symptoms, severity of the condition, etc. Among these surgeries, FESS has proven to be one of the safest and most effective treatments.

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