Rhinosinusitis: A Retrospective Analysis of Clinical Pattern and Outcome in North Western Nigeria

RESUMO

Background/Objectives: Rhinosinusitis is the commonest viral infection in man and the commonest inflammatory disorder encountered by general practitioners; chest physicians; and otorhinolaryngologists all over the world. The clinical pattern and outcome of conventional management measures were assessed. Method: All new patients with the diagnosis of rhinosinusitis over a 2-year period from July 1999 to July 2001 were analyzed for clinical features; conventional radiological findings; and treatment modalities over a period of 3 years follow up. Results: There were 195 (11.7) new cases of rhinosinusitis out of a total number of 1661 patients seen over the period under review. Only 146 case notes were accessible for the study. Eighty-four (57.5) were males and 62 (42.5) were females. Their ages ranged from 7 months to 70 years. The main clinical symptoms and signs were nasal discharge or rhinorrhea (84.9); nasal obstruction (24.7); epistaxis (22.0); and sneezing (20.6). The duration of symptoms ranged from few days to about 10 years with 24 (16.4) being acute cases while 122 (83.6) were chronic cases giving a prevalence of 1.4and 7.3; respectively. Maxillary sinus (58.9) was the commonest sinus involved. More than one sinus involvement accounted for 37.7of the cases. Infective causes accounted for 67.1of cases followed by allergy (28.8). There were complications in 21 (14.4) cases with orbital involvement (33.3) being the commonest complication. Mode of treatment were medical (86.3); and conventional surgery was carried out in 13.7of the cases for either failed medical treatment or associated complications. Facial paraesthesia along the sites of surgery was the commonest complications; otherwise the outcome of treatment was excellent. Conclusion: Rhinosinusitis in this region was more of chronic (83.6) variety than acute (16.4) variety. Infective causes (67.1) and allergy (28.8) were the commonest etiological factors. About (86.3) were amendable to medical treatment while surgical treatment was carried out in 13.7of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist; conventional surgical measures may be used