A patient came to gen med opd with c/o headache and tiredness In op sheet COAS was written N referred to ent opd What could it be
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COAS medical abbreviation "catarrh of antrum" sinusitis ENT
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Here's the full clinical picture:
COAS = Catarrh Of Antrum & Sinuses
This is a common abbreviation used in Indian clinical practice (especially in OPD notes). It refers to mucosal inflammation and mucus congestion of the maxillary antrum (sinus) and paranasal sinuses - essentially chronic sinusitis/rhinosinusitis.
Why this fits perfectly:
| Feature | Explanation |
|---|---|
| Headache | Sinus headache - dull, pressure-type, often frontal or periorbital, worse on bending forward |
| Tiredness/fatigue | Chronic mucus congestion, post-nasal drip, and low-grade inflammation cause systemic fatigue |
| Referred to ENT | Antrum (maxillary sinus) and sinus disease is managed by ENT |
What is the Antrum?
The antrum of Highmore = the maxillary sinus - the largest paranasal sinus, located in the cheekbone. "Catarrh" refers to mucous membrane inflammation with mucus buildup.
Clinical Features of COAS:
- Headache (frontal, facial, vertex)
- Nasal congestion / blocked nose
- Post-nasal drip
- Fatigue / malaise
- Sometimes low-grade fever
- Facial tenderness over the cheeks/forehead
- Halitosis
ENT Management typically includes:
- Nasal decongestants (xylometazoline, oxymetazoline)
- Saline nasal irrigation
- Intranasal corticosteroids (mometasone, fluticasone)
- Antibiotics if bacterial superinfection (amoxicillin-clavulanate)
- Antihistamines if allergic component
- Functional Endoscopic Sinus Surgery (FESS) for chronic/refractory cases
In short: The general physician recognized headache + fatigue as likely sinus-related, wrote COAS (Catarrh Of Antrum & Sinuses), and appropriately referred to ENT for further workup (nasal endoscopy, sinus X-ray or CT PNS) and management.
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