Chronic sinusitis is a common ENT condition where patients suffer from nasal congestion, runny nose and headaches. Today, we talk about the prevention and treatment of chronic sinusitis. First, we need to briefly understand the structure of the nasal cavity and sinuses. Sinuses, also known as paranasal sinuses, paranasal sinuses, are distributed in the nasal cavity around the air-containing bony cavities, maxillary sinuses are located on both sides of the nasal cavity, below the orbit of the maxilla; frontal sinuses in the frontal bone; sieve sinuses are located on both sides of the upper part of the nasal cavity, by the sieve tube within the many air-containing small cavities; pterygoid sinus in the back of the nasal cavity in the pterygoid bone. They all have their own openings with the nasal cavity. The sinuses have a variety of physiological functions, and in addition to being involved in moisturizing and warming the inhaled air, they also play an important role in styling a person’s face, supporting the interior of the head, and reducing the weight of the head. How is chronic sinusitis defined? Chronic sinusitis is a chronic inflammation of the mucous membranes of the nasal cavity and sinuses that lasts more than 12 weeks. Two important concepts are included here, first, the simultaneous presence of inflammation of the nasal and sinus mucosa. Inflammation of the sinus mucosa alone and the nasal mucosa is normal in the clinic is almost none, all sinusitis will be accompanied by inflammation of the nasal mucosa, and many sinusitis began to appear first is the symptoms of rhinitis. For this reason, the international terminology of rhinosinusitis is now used to replace the previous concept of sinusitis (we still use the term “chronic sinusitis” here). Secondly, the duration of the disease should be more than 12 weeks, that is to say, symptoms such as nasal congestion and runny nose should last for more than 3 months before it can be called chronic inflammation. Generally speaking, inflammatory diseases with a duration of less than 1 month are considered acute, 1 month to 3 months are considered subacute, and more than 3 months are considered chronic, and sinusitis is also divided in this way. What are the symptoms of chronic sinusitis? The main symptoms of chronic sinusitis are nasal congestion, runny nose (sticky or mucopurulent mucus, which is often called “sticky nose”), accompanied by head and face swelling and pain, and loss of sense of smell. The examination includes nasal endoscopy and sinus CT, endoscopy can see nasal mucosal edema, sometimes the olfactory fissure area or the middle nasal tract can see pus. Sinus CT is one of the important tests to diagnose the degree of sinusitis lesions, it can reflect the lesions in those groups of sinuses, and at the same time, it can suggest what anatomical structure of the nasal cavity, sinus abnormalities, for the development of the treatment program (whether the need for surgery) to provide an important basis. What are the causes of chronic sinusitis? Chronic sinusitis is a disease with complex etiology and more causes, mainly in the following aspects: 1, external factors: Infectious factors are the primary factors causing sinusitis, mainly caused by viruses, bacteria, fungi and parasites. For example, like acute rhinitis, which is usually said to be a cold, if the treatment is not complete, it is easy to lead to sinusitis, prolonged is chronic sinusitis. In addition, non-infectious factors are also important factors causing chronic sinusitis, such as: allergic rhinitis, drug rhinitis. 2, intrinsic factors: including genetic factors (such as mucosal cilia structure and dysfunction) and acquired factors: ① aspirin hypersensitivity reaction related asthma and nasal polyps; ② autonomic dysregulation; ③ endocrine changes; ④ sinus mouth and nasal tract complex anatomical variations and obstruction disorders; ⑤ autoimmune and idiopathic factors; ⑥ immune deficiencies; ⑦ allergy and immunological factors; to sum up, it is mainly exogenous (⑤). In summary, it is mainly the result of the interaction between external factors (environmental factors, such as pathogenic microorganisms, environmental pollutants, drugs and trauma) and internal factors (local factors, such as acquired mucous cilia dysfunction, nasal structural anomalies and hyperplasia; and systemic factors, such as allergic reactions, congenital mucous cilia dysfunction, immune deficiencies, and neuroendocrine dysfunctions). Various etiologic mechanisms are intertwined and interact with each other. Therefore, the understanding of the causative factors and pathogenesis of chronic sinusitis should be a holistic process. How to treat chronic sinusitis? Many patients believe that sinusitis requires surgery, but in fact, surgery is not a panacea. Chronic sinusitis mainly relies on medication, surgery is only to remove some anatomical abnormalities or new growths, smooth sinus drainage channels. First of all, the condition needs to be fully evaluated according to the medical history, endoscopy and sinus CT results, and surgery can be performed if there is one of the following conditions: (1) obvious anatomical abnormalities affecting the drainage of each sinus; (2) nasal polyps affecting the drainage of each sinus; (3) unsatisfactory improvement of the symptoms by medication; and (4) intracranial, intraorbital, and other complications. Drug treatment includes: 1, “Western medicine” treatment: (1) Hormones: including intranasal glucocorticoids (such as Renoxolone, Cochlear, etc.) and systemic glucocorticoids (prednisone), which can effectively reduce the nasal cavity, sinus mucosal edema. (2) Oral antibiotics: 14 metacyclic macrolides (e.g., clarithromycin) have anti-inflammatory and immunomodulatory effects. (3) Mucolytic pro-discharge agents: can thin nasal and sinus secretions and improve nasal mucosal cilia activity, promote mucus discharge, such as standard myrtle oil enteric capsule, eucalyptus pinene enteric capsule. (4) Anti-allergic drugs: patients with allergic rhinitis and (or) asthma can apply anti-allergic drugs, including oral or nasal antihistamines. For patients with asthma, oral leukotriene receptor antagonists are preferred. 2, Chinese medicine treatment: Chinese medicine diagnosis and treatment in clinical practice has accumulated a lot of valuable experience, Chinese medicine preparation as an auxiliary method of treatment of chronic sinusitis, depending on the condition according to the principle of diagnosis and treatment, discretionary use. 3.Nasal irrigation treatment: Nasal irrigation is an effective means of treating chronic sinusitis, and it is also a commonly used adjunctive treatment after nasal endoscopic surgery. Surgical treatment is currently the mainstream of functional nasal endoscopic sinus surgery, nasal endoscopic surgery is the use of high-resolution, changeable angle of view of the nasal endoscope to carry out sinus surgery, so that the nasal cavity, sinuses, especially deep surgery can be carried out under direct vision. It has the advantages of less tissue damage, less bleeding, clear intraoperative vision and fewer complications. Chronic sinusitis how to prevent and control: 1, nasal congestion, runny nose should be timely to the hospital, especially children, in order to prevent delayed treatment into chronic; 2, adhere to physical exercise, improve body resistance. 3, actively prevent colds and flu, timely treatment in the upper respiratory tract infection period, because the upper respiratory tract infection treatment is incomplete, often become the cause of chronic rhinitis and chronic sinusitis. 4, working environment dust, pollution, should wear a mask, avoid bacteria into the nasal cavity. 5, active treatment of chronic rhinitis, banning spicy; fatty stimulating food, quit smoking and alcohol.