What are chronic sinusitis and nasal polyps?
Chronic rhinosinusitis describes persistent inflammation affecting the nose and sinuses. Symptoms can include nasal blockage, discharge or post-nasal drip, reduced smell and facial pressure. Nasal polyps are soft, non-cancerous swellings that may contribute to blockage and loss of smell.
When to see a sinusitis and nasal polyps specialist
- Symptoms persisting despite appropriate medical treatment
- Recurrent episodes of sinus disease
- Significant nasal blockage or impaired smell
- Suspected or known nasal polyps
- Predominantly one-sided or otherwise unusual symptoms
Your sinus and nasal polyp consultation in Ashford
The consultation focuses on the pattern and duration of symptoms, previous treatment, asthma/allergy history, previous nasal surgery and relevant medications. Nasal endoscopy may be recommended. CT imaging is used selectively when it will help diagnosis or surgical planning.
Smell loss testing in Kent: 16-odour identification
I offer the 16-odour Sniffin’ Sticks identification test as part of my assessment of a reduced or lost sense of smell. During this non-invasive test, you smell a series of scented pens and choose the best match from four options for each odour.
I use smell identification testing to support:
- Chronic rhinosinusitis with nasal polyps (CRSwNP): assessing the effect of nasal polyps and sinus inflammation on your ability to identify smells.
- Dupilumab treatment monitoring: tracking changes in smell in patients receiving dupilumab for CRSwNP, alongside symptoms and the wider clinical assessment.
- Post-viral olfactory loss, including after COVID-19: assessing a reduced or lost sense of smell following a viral infection and monitoring changes over time.
The score provides a baseline that can be compared with repeat testing at follow-up. I interpret the results alongside your symptoms, medical history and examination to guide advice and an individual management plan.
Treatment options for sinusitis and nasal polyps
Many patients are treated medically, often with saline irrigation and topical nasal steroid treatment when appropriate. The exact plan depends on diagnosis and individual factors. Surgery may be discussed when symptoms remain troublesome despite appropriate medical treatment or when there is another specific indication.
When endoscopic sinus surgery (FESS) is considered
Endoscopic sinus surgery (FESS) aims to improve access and drainage through the natural sinus pathways and, in chronic inflammatory disease, can also help topical treatments reach the sinus cavities more effectively. Surgery does not remove the underlying tendency to inflammation, so ongoing medical treatment may still be required.
Severe nasal polyps and the East Kent biologics MDT
In my NHS practice, I co-established the East Kent One Airway Biologics multidisciplinary team. The team supports the assessment of patients with severe chronic rhinosinusitis with nasal polyps, including consideration of specialist biologic treatment where appropriate.
Assessment and treatment follow the relevant NHS referral pathway, eligibility criteria and multidisciplinary review.