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Rhinosinusitis: Why Does My Rhinosinusitis
Persist?
Patients with chronic rhinosinusitis often improve with medical
treatment (such as antibiotics) but quickly experience a relapse when
the treatment is stopped. In some patients, symptoms never completely
subside.
In chronic rhinosinusitis, infection is only part of the problem. The
tissue lining the sinuses becomes thickened, and this leads to
obstruction of the sinus ostia. There are three critical drainage
pathways for the sinuses on each side of the face. These are:
- ostiomeatal unit - This is the most important drainage
area, since it drains the anterior ethmoid and maxillary sinus.
Obstruction of the ostiomeatal unit may give symptoms of facial
fullness, pressure between the eyes, cheek pressure, loss of sense
of smell and postnasal drainage.
- nasofrontal duct - This pathway drains the frontal sinus.
Obstruction of the nasofrontal duct may give symptoms of forehead
pressure, headaches, heaviness in the head and postnasal drainage.
- sphenoethmoidal recess - This pathway drains the
posterior ethmoid and sphenoid sinuses. Obstruction of the
sphenoethmoidal recess may give symptoms of facial fullness,
facial pressure, pressure between the eyes, vague headaches and
postnasal drainage.
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