For as many as one in five of us, spring signals the start of allergy season and the daily misery of congestion, sneezing and hay fever. But when sinus pain, a blocked nose, facial pressure or swelling keeps recurring, it may be a sign of an underlying cause rather than seasonal allergies alone.
Ear, nose and throat (ENT) surgeons practising at Netcare Waterfall City Hospital, Dr Tercia Tsakani Nkuna-Shilenge and Dr Sebenele Maseko share their insights into the nasal and sinus conditions that can range from minor annoyance to severe facial pain and obstructed breathing.
| Dr Sebenele Maseko is one of the Ear, nose and throat surgeons practising at Netcare Waterfall City Hospital.
“Seasonal allergic rhinitis, also known as ‘hay fever’, affects between 10% and 20% of the general population, with an even greater prevalence among children. It’s particularly common in spring, when there are higher pollen counts and more dust particles in the air, and usually lasts only a few weeks before resolving,” says Dr Maseko.
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| ENT surgeon Dr Tercia Tsakani Nkuna-Shilenge says that environmental triggers contribute to both allergic rhinitis and chronic sinusitis. |
Rhinitis is a group of similarly presenting nasal disorders characterised by symptoms such as sneezing, nasal itching, watery eyes, a watery or runny nose, or nasal congestion. When one or more of these symptoms persist for longer than 12 weeks, it is considered chronic rhinitis.
“The symptoms of rhinitis and sinusitis overlap, with sinusitis rarely occurring in the absence of rhinitis. Both conditions are caused by inflammation of the nose and paranasal sinuses,” Dr Maseko points out.
Swelling of the mucosal membranes inside the nasal passages and the sinuses, which are small air pockets in the facial bones, may block drainage, leading to fluid accumulation in the sinuses where infection, known as rhinosinusitis, is likely to develop.
Highveld triggers
Dr Nkuna-Shilenge says that environmental triggers contribute to both allergic rhinitis and chronic sinusitis. “In Gauteng, we see patients whose symptoms are aggravated by environmental factors. The dry Highveld climate, dust, grass pollen, smoke, traffic fumes, air pollution, and seasonal changes can all worsen allergic rhinitis and sinus inflammation,” she says.
“For people who already have allergies, asthma, nasal polyps or chronic rhinosinusitis, these environmental exposures may contribute to more frequent or more severe symptoms.”
In addition, chronic rhinitis can stem from non-allergic causes, such as infections and hormonal factors, including pregnancy-associated rhinitis. People who work with chemicals or in cold storage conditions may also experience irritation of their nasal passages.
“The symptoms of rhinitis and sinusitis overlap, and sinusitis rarely occurs in the absence of rhinitis. Both conditions are caused by inflammation of the nose and paranasal sinuses, and both can erode quality of life and aggravate comorbid conditions if they are not addressed,” adds Dr Maseko.
| Allergic fungal rhino sinusitis: A scan shows the blocked sinuses of a person with allergic fungal rhino sinusitis. |
| Healthy sinus: Scan of a healthy sinus, with black areas indicating clear sinuses. |
“Chronic sinus problems are usually due to ongoing inflammation rather than infection alone, with contributing factors including allergic rhinitis, recurrent viral upper respiratory tract infections, asthma, nasal polyps, a deviated nasal septum, enlarged turbinates, irritant exposure and, in certain cases, immune problems or fungal sinus disease,” explains Dr Nkuna-Shilenge.
Chronic sinus disease signs and symptoms
- Lasts for more than 12 weeks
- Blocked nose
- Thick nasal discharge
- Post-nasal drip in the back of the throat
- Reduced sense of smell
- Facial pressure
- Headaches and fatigue
Snoring too?
Inside the nose, a wall of cartilage and bone called the septum separates the right and left sides of the nose. It’s not unusual for the septum to be slightly skewed, but in more severe cases a deviated septum can narrow the nasal airway and cause persistent nasal obstruction.
“With this condition, people may experience difficulty breathing through the nose, mouth breathing, snoring, poor sleep, dryness, nosebleeds or a feeling of being blocked and unable to clear mucus. This can also interfere with normal airflow and sinus drainage, often contributing to recurrent sinus symptoms,” says Dr Nkuna-Shilenge.
Dr Maseko adds that the septum can be deviated to one side due to trauma, chronic rhinosinusitis with polyps, tumours and other causes. “A deviated septum can worsen symptoms or mimic rhinitis or sinusitis. Where necessary, a deviated nasal septum can be corrected surgically with a procedure called septoplasty,” she says.
Don’t suffer in silence
Mild symptoms may improve with medical treatment, such as saline nasal rinses, allergy management and steroid nasal sprays, especially where there is associated rhinitis. These treatments can reduce swelling and improve airflow, but they cannot physically straighten the septum.
Any persistent nasal symptoms should be further evaluated by an ENT specialist, also known as an otorhinolaryngologist. Conveniently book an appointment with a general practitioner, ENT surgeon or other specialist practising at a Netcare facility near you on the Netcare App or by calling the Appointmed service on 0860 5555 65.
Medical attention is urgently needed for swelling around the eye, visual changes, a severe or unusual headache, confusion, neck stiffness, high fever or facial swelling. Repeated nosebleeds, bleeding or foul-smelling discharge, or symptoms experienced mainly on one side, such as one-sided nasal blockage, also require immediate treatment.
“Sinus-related complaints are very common, but symptoms like nasal blockage, post-nasal drip, facial pressure and headaches do not always originate from the sinuses. A full ear, nose and throat history and examination are important to identify the true cause,” concludes Dr Nkuna-Shilenge.
Ends.
Notes to editors
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Issued by: MNA on behalf of Netcare Waterfall City Hospital
For media enquiries Martina Nicholson, Meggan Saville, Estene Lotriet-Vorster,
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