Rhinitis & Sinusitis
Rhinitis & Sinusitis
A persistently blocked or runny nose, facial pressure, or reduced sense of smell can significantly affect your quality of life — yet these symptoms are often undertreated or managed with over-the-counter remedies that don't address the underlying cause. Ms Mushi provides expert assessment of rhinitis and sinusitis, with direct access to nasendoscopy and CT scanning to reach an accurate diagnosis quickly.
What is rhinitis?
Rhinitis is inflammation of the lining of the nose, causing congestion, a runny nose, sneezing and sometimes loss of smell. There are several types, each with different triggers and treatments.
Allergic rhinitis
The most common form, triggered by allergens such as house dust mites, pet dander, pollen or mould. Symptoms may be seasonal (hay fever) or year-round (perennial allergic rhinitis).
Perennial allergic rhinitis
Causes persistent symptoms regardless of the time of year and is frequently associated with inferior turbinate hypertrophy — swelling of the bony structures inside the nose that worsens congestion.
Rhinitis medicamentosa
An often-overlooked condition caused by overuse of decongestant nasal sprays such as Sudafed or Otrivine. These sprays cause rebound congestion when they wear off, creating a cycle of dependency. Stopping the spray — with the right support — is the primary treatment.
Non-allergic rhinitis
Produces similar symptoms without an identifiable allergic cause, and may be related to environmental irritants, hormonal changes or structural factors such as a deviated nasal septum.
What is sinusitis?
The sinuses are air-filled cavities around the nose and eyes. Sinusitis occurs when these become inflamed, usually following a viral infection or in association with rhinitis. Acute sinusitis typically follows a cold and resolves within a few weeks. Chronic rhinosinusitis is defined as symptoms lasting more than 12 weeks and often requires specialist assessment. Nasal polyps are soft, non-cancerous growths associated with chronic rhinosinusitis that can cause significant nasal obstruction and loss of smell.
Particularly around the cheeks, forehead or behind the eyes.
Persistent blockage or coloured discharge that does not clear.
Hyposmia or anosmia, often one of the most distressing symptoms.
Mucus dripping down the back of the throat, causing cough or throat clearing.
A feeling of pressure or heaviness in the face, particularly when bending forward.
Soft growths in the nasal passages that cause obstruction and loss of smell, associated with chronic sinusitis.
How Ms Mushi assesses and treats rhinitis and sinusitis
At your consultation
Ms Mushi will take a detailed history including the nature, duration and triggers of your symptoms, any previous treatments tried, and relevant factors such as pets, occupational exposures or use of nasal sprays. In most cases she will perform a flexible nasendoscopy in clinic, which allows direct assessment of the nasal passages, turbinates and postnasal space. Where deeper sinus disease is suspected, a CT scan of the paranasal sinuses will be arranged.
Medical management
First-line treatment for most patients includes Dymista (fluticasone/azelastine), a combined intranasal steroid and antihistamine spray used twice daily for a minimum of three months. This is combined with twice-daily nasal douching using NeilMed saline sachets to clear discharge and improve spray penetration. Allergen avoidance advice is provided where relevant, and a structured withdrawal plan is offered for patients dependent on decongestant sprays.
Surgical options
For patients whose symptoms do not respond adequately to medical treatment, surgery offers effective, lasting relief.
Septoplasty
Correction of a deviated nasal septum to restore airflow through both sides of the nose. Performed under general anaesthetic as a day-case procedure.
Inferior turbinate reduction
Reducing enlarged turbinates to relieve nasal obstruction. Often performed alongside septoplasty for patients with combined structural and mucosal causes of blockage.
Functional endoscopic sinus surgery (FESS)
Minimally invasive surgery to open blocked sinuses, typically for chronic rhinosinusitis or nasal polyps that have not responded to medical treatment.
When should you seek a private ENT opinion?
A private consultation with Ms Mushi means you will be seen within days, with nasendoscopy and a clear management plan at the same appointment.
Nasal congestion or blocked nose lasting more than a few weeks
Facial pain or pressure not explained by a cold
Loss or reduction in your sense of smell
Symptoms that have not improved with over-the-counter antihistamines or nasal sprays
Suspected nasal polyps
Regular use of decongestant sprays for more than two to three weeks
Previous sinus surgery with recurrent symptoms
Frequently asked questions
Can allergic rhinitis be cured?
Allergic rhinitis cannot be cured but can be very well controlled with the right medication and allergen avoidance measures. In selected patients, allergen immunotherapy (desensitisation) may be considered, and Ms Mushi can advise on whether this is appropriate.
What is the difference between a cold and sinusitis?
A cold typically resolves within 7–10 days. Sinusitis should be suspected when facial pain, congestion and discharge persist beyond 10 days, or worsen after initially improving. Chronic sinusitis is diagnosed when symptoms last more than 12 weeks.
Do I need a CT scan?
Not always. Many patients with rhinitis can be diagnosed and treated without imaging. A CT scan of the sinuses is arranged when there is suspicion of chronic sinus disease, nasal polyps, or symptoms that have not responded to initial treatment.
Is nasal surgery painful?
Septoplasty and turbinate reduction are performed under general anaesthetic and most patients are surprised by how little discomfort they experience afterwards. There is typically a period of nasal congestion during healing, but the long-term improvement in breathing is usually significant.
Can I use a decongestant spray while waiting for my appointment?
Decongestant sprays such as Otrivine or Sudafed nasal spray should not be used for more than 5–7 days at a time. If you have been using one regularly, mention this at your appointment as it may be contributing to your symptoms.
Book a consultation for rhinitis or sinusitis
Ms Mushi sees patients with nasal and sinus symptoms at Circle Cheshire Clinic, Northwich. Appointments are typically available within days.