Author Interviews, ENT / 03.06.2019 Interview with: Edward McCoul, MD, MPH, FACS Associate Professor Director, Rhinology and Sinus Surgery Department of Otorhinolaryngology Ochsner Clinic New Orleans, Louisiana What is the background for this study? What are the main findings? Response: Although the potential for doctors and patients to misunderstand each other has been noted in other areas of medicine, the meaning of the word "congestion" had not previously been the subject of study.  This paper calls attention to the relevance of potential communication gap in otolaryngology.  This is particularly important since congestion is a major diagnostic criteria of sinusitis, which ranks nationwide in the top 5 reasons for clinical encounters year after year.  If a communication gap is evident around this particular term, which is integral to establishing a diagnosis of sinusitis, then the likelihood increases that patients who present with "sinusitis" will be incorrectly diagnosed. The process of congestion refers to the microscopic accumulation of blood and/or fluid within cells or the spaces between cells in a particular tissue or body part.  When this occurs in the nose, the result is swelling inside the nose, which narrows the space for air to flow.  A patient would perceive this as blockage or obstruction of airflow.  This can be treated with anti-inflammatory medication that reduces swelling.  Medications that clear up mucus generally are not great at reducing swelling.  Many over-the-counter products are available that combine both types of medications, but using those products runs the risk of overmedication, which can have adverse consequences. (more…)