Transcript
Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, we’ll hear from Dr. Amber Luong, who’s a Professor of Otorhinolaryngology Head and Neck Surgery at the McGovern Medical School at UTHealth Houston. She’ll be discussing the diagnosis of chronic rhinosinusitis with and without nasal polyps.
Here’s Dr. Luong now.
Dr. Luong:
So chronic rhinosinusitis is diagnosed based on having symptoms for longer than three months—two out of the four cardinal symptoms. So those cardinal symptoms are facial pain and pressure, loss of sense of smell or decreased sense of smell, nasal obstruction, and discolored drainage. So if someone presents with two of those symptoms lasting longer than three months, then you start thinking about the diagnosis of chronic rhinosinusitis.
But then you also need evidence of inflammation of the lining of the sinuses. So that evidence comes either objectively, through a nasal endoscopy—which is where we put a camera in the nose and look for evidence of inflammation in the sinus cavity—or a CT sinus scan, where you can highlight inflammation of the lining of the sinuses there. It's differentiated from other diagnoses—the most common one is allergic rhinitis—by some of these objective findings.
Differentiating between the two phenotypes of CRS is this presence or absence of nasal polyps. And so that can be noted using a nasal endoscopy, so you can physically see the polyps in the nasal cavity or not. This can also be illuminated with a CT sinus scan, although you really have to be pretty comfortable or familiar with reading CT sinus scans, because it's hard to differentiate gray from white. All gray looks the same. So polyps can be seen medial, meaning towards or closer to the septum, of the middle turbinate. And that's where grayness in that area may make you think about nasal polyps.
Announcer:
That was Dr. Amber Luong talking about how to identify chronic rhinosinusitis with and without nasal polyps. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
