Under what conditions should a patient with sinusitis be referred to ENT?

Referring a patient with sinusitis to an Ear, Nose, and Throat (ENT) specialist is appropriate when they experience more than three episodes requiring antibiotics in a year. This situation suggests that the sinusitis may be recurrent or chronic and may require further evaluation and management beyond typical primary care practices. Chronicity can lead to potential complications or underlying anatomical issues that should be assessed by a specialist.

Patients who fall into this category may benefit from additional diagnostic procedures, such as imaging studies or endoscopic examination, to better understand the causes of their frequent infections. Chronic sinusitis can have various etiologies that an ENT is equipped to investigate and address, which can help in managing symptoms effectively and preventing future episodes.

In contrast, options like nasal irrigation, over-the-counter decongestants, and common cold symptoms do not indicate that the patient's condition has reached a level that necessitates specialist referral. These scenarios are typically manageable within a primary care setting and do not reflect the recurring or complex nature that would warrant an ENT evaluation.