A 35-year-old female presents with a 10-month history of persistent nasal congestion, facial pressure, and a postnasal drip. She reports a constant sensation of fullness in her face, particularly around the sinuses, along with intermittent headaches that are worse in the morning. She also complains of a reduced sense of smell and taste, and has experienced occasional sore throat and cough, particularly at night. She has tried over-the-counter antihistamines and nasal decongestants without significant relief. Her medical history is significant for allergic rhinitis, but she has no history of asthma or frequent sinus infections. She denies fever, purulent nasal discharge, or dental pain. On physical examination, she has mild tenderness to palpation over the maxillary sinuses, and nasal endoscopy shows mild mucosal swelling in the middle meatus. A CT scan of the sinuses confirms mucosal thickening in the ethmoid and maxillary sinuses, consistent with chronic rhinosinusitis.

Chronic Rhinosinusitis.

The patient is advised to start a combination of nasal corticosteroids and saline nasal irrigation, along with a course of oral antibiotics for possible superimposed bacterial infection. Referral to an ENT specialist is made for further evaluation, including possible surgical intervention if conservative management fails.