sinonasal

Sinonasal refers to the anatomical region that includes the nasal cavities and the paranasal sinuses, which consist of the maxillary, frontal, ethmoid, and sphenoid sinuses. The sinonasal mucosa lines this network and functions to filter, humidify, and drain secretions. Adequate drainage through the ostiomeatal complex is essential for sinus health and ventilation.

Clinically, sinonasal disease commonly presents with nasal obstruction, facial pressure or pain, reduced sense of smell, nasal discharge, and sometimes fever. Common conditions include acute and chronic rhinosinusitis, chronic rhinosinusitis with or without nasal polyps, allergic rhinitis, and nasal polyposis. Less frequently encountered issues include fungal sinusitis and tumors of the sinonasal tract. Etiologies span infectious (viral or bacterial), inflammatory and allergic processes, and anatomical or structural obstructions such as a deviated septum or enlarged turbinates.

Diagnosis relies on a combination of history, nasal endoscopy, and imaging. Computed tomography (CT) is the preferred modality to delineate sinus anatomy and disease extent, while magnetic resonance imaging (MRI) is used when there is concern for orbital or intracranial extension or for evaluating tumors. Biopsy may be necessary for suspicious masses or atypical presentations.

Treatment aims to restore drainage and control inflammation. Medical management includes intranasal corticosteroids, saline irrigation, analgesics, and antibiotics when bacterial infection is suspected. Allergic disease may require immunotherapy or systemic steroids in select cases. Refractory or extensive disease often necessitates endoscopic sinus surgery to reestablish normal drainage pathways.

Prognosis varies with the condition; chronic rhinosinusitis can be a long-term, relapsing disease, while sinonasal tumors require oncologic evaluation and treatment.