In this episode of The Good GP, host Dr Krystyna de Lange is joined by Dr Jo-Lyn McKenzie, an ENT surgeon, researcher, and university lecturer based in Brisbane, for a discussion on chronic rhinosinusitis and its management in primary care.

Dr McKenzie begins by outlining the key clinical features that distinguish chronic rhinosinusitis from other common nasal conditions. Highlighting the importance of chronic nasal obstruction and persistent discharge, and that chronicity, which is greater than three months of symptoms, is a critical factor in making the diagnosis. Dr McKenzie also addresses the challenges of differentiating between chronic sinusitis and allergic rhinitis, its differences in symptom persistence, the nature of the discharge, and the utility of detailed history-taking.

They discuss the value and technique of medical management in the general practice setting. Detailing the use of high-volume saline nasal irrigation and intranasal corticosteroids as first-line treatments, providing practical tips to improve patient compliance and effectiveness. She stresses the importance of correct technique and regular use, addressing common misconceptions about side effects. 

Referral to ENT is discussed, with Dr McKenzie explaining when specialist review is indicated. She also comments on the accessibility of ENT services in both public and private settings.

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