Chronic rhinosinusitis is one of the most common diseases affecting the upper respiratory tract. It is estimated to affect approximately 15% of the population and can significantly impair daily life by causing poor sleep, persistent fatigue, headaches, nasal congestion and reduced quality of life.
What is Chronic Rhinosinusitis?
Rhinosinusitis is an inflammation involving both the nasal mucosa and the paranasal sinuses. Since these structures are almost always affected together, the term rhinosinusitis is preferred over simply "sinusitis."
According to symptom duration, rhinosinusitis is classified as:
- Acute rhinosinusitis – symptoms lasting up to 4 weeks;
- Subacute rhinosinusitis – symptoms lasting 4–12 weeks;
- Chronic rhinosinusitis – symptoms persisting for more than 12 weeks.
What Causes Chronic Rhinosinusitis?
Under normal conditions, mucus produced in the sinuses is continuously transported into the nasal cavity by the ciliated epithelium. When the sinus drainage pathways become blocked, mucus accumulates and thickens, creating conditions that maintain chronic inflammation.
Several factors may contribute to the development of chronic rhinosinusitis, including:
- impaired sinus drainage;
- excessive or thickened mucus production;
- reduced ciliary function;
- smoking;
- air pollution and other environmental factors.
Common Symptoms
Unlike acute sinus infections, chronic rhinosinusitis does not always present with fever. Instead, patients often experience persistent symptoms that gradually interfere with everyday activities.
Common symptoms include:
- headache and facial pressure;
- pain radiating toward the teeth;
- nasal congestion;
- excessive nasal discharge;
- postnasal drip;
- nighttime or morning cough;
- bad breath;
- disturbed sleep;
- morning fatigue;
- ear discomfort or pressure.
Headache is one of the most common reasons patients seek medical attention. In chronic rhinosinusitis it is often associated with pressure changes within the paranasal sinuses and may help physicians identify the affected sinus.
Treatment Options
Treatment should always be individualized according to the patient's condition, symptom severity and underlying cause.
Depending on the clinical situation, therapy may include:
- antibiotics when indicated;
- corticosteroids;
- isotonic or hypertonic saline irrigation;
- additional anti-inflammatory medications;
- herbal preparations as part of an integrated treatment approach.
In recent years, there has been growing interest in phytotherapeutic products that may help relieve symptoms and may be suitable for longer-term use.
Clinical Experience with Cefagrain
A clinical observational study was conducted at Lozenets University Hospital involving patients with chronic rhinosinusitis, including individuals with concomitant asthma. Patients aged 10 to 70 years received Cefagrain according to the manufacturer's recommended regimen of two tablets twice daily for 12 weeks.
Opinion of Associate Professor Petar Kabakchiev, MD
"Our observations demonstrated encouraging results in patients taking Cefagrain, particularly regarding headache relief, improved nasal breathing and reduction of nasal and postnasal secretions."
"The absence of serious adverse effects further supports the potential use of Cefagrain in patients with long-standing complaints associated with chronic rhinosinusitis."
"Follow-up examinations also revealed no significant changes in routine blood and urine laboratory parameters."
What is Cefagrain?
Cefagrain is a polyherbal formulation developed by Charak Pharmaceuticals based on Ayurvedic medicinal plants. In the clinical observation conducted at Lozenets University Hospital, it was used as part of the therapeutic approach for patients with chronic rhinosinusitis.
According to the investigators' observations, Cefagrain helped:
- reduce sinonasal inflammation;
- facilitate mucus liquefaction and drainage;
- relieve headache associated with chronic rhinosinusitis;
- improve patients' comfort and quality of life.
Conclusion
Chronic rhinosinusitis is a long-term condition that can significantly affect quality of life if left untreated. Effective management requires accurate diagnosis, individualized therapy and regular medical follow-up.
For selected patients, herbal products may serve as a useful adjunct to conventional treatment. Clinical observations conducted at Lozenets University Hospital demonstrated favorable outcomes with Cefagrain in relieving the major symptoms of chronic rhinosinusitis while showing a good tolerability profile.
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