Sinusitis is the term used to describe symptoms such as congestion or blockage of the nose, and nasal discharge along with facial congestion, pressure or pain. Sometimes there is associated infection leading to green or yellow nasal secretions. It can be a distressing condition. Allergy can sometimes lead to this, but a wide range of other conditions can also lead to these difficult symptoms. Nasal polyps (growth of inflamed sinus lining tissue into the nose) can present with severe nose blockage and lack of smell (termed anosmia). Given that the nasal passages and sinuses are part of the Respiratory System, diseases that are more commonly associated with the lung breathing tubes can occur in the nose and sinuses, often before it manifests lower down in the lungs. The best care is provided by a team approach between Allergy-Respiratory-Rhinology trained physicians and ENT surgeons working together. Medical Rhinology is a growing and very exciting speciality as it is very broad-based in terms of different diseases that can present through the nose and upper airway and utilises key aspects of training in Allergy, Immunology, Microbiology and Respiratory Medicine. In addition it is a very hands-on speciality, with evaluation of complex head and neck anatomy both by endoscopic inspection and radiological investigation. There is pressing need for more focussed research in the area to understand the disease mechanisms better and thus develop better treatments.

Figure 1 (Top Right): Individuals with nose and sinus disease often feel they have a constant head cold.

Figure 2 (Bottom Right): CT scan of nose and associated sinus anatomy demonstrating the intimate relationship of upper airway structures. Several conditions can lead to nose and sinus symptoms, and CT scanning can be helpful in making an exact diagnosis and guide treatment.

CT Scan of sinuses