What is Sinusitis?
Inflamm of mucosal lining of paranasal sinuses
What is Sinusitis usually accompanied by?
Rhinosinusitis (inflamm of nasal cavity)
What is the time frame of Acute vs Chronic Sinusitis?
Acute: under 12 wks
Chronic: over 12 wks
What are the Paranasal sinuses?
4 sets of hollow spaces within bones of face
What is the function of the Paranasal sinuses? (2 things)
- Produce mucous
- Drain into Nasal cavities via ostia (holes)
What happens when the Ostia are blocked?
Paranasal sinuses cant drain into Nasal Cavities anymore
–> Sinusitis
What are the causes of Sinusitis? (4 things)
- Infection (Influenza / Rhinovirus / Adenovirus / Nasopharynx bac)
- Allergies (hayfever)
- Drainage obst (foreign body / trauma / polyps)
- Smoking
What are the risk factors for Sinusitis? (6 things)
- Age
- Asthma
- Smoking
- Recurrent URTIs
- Bone deformation
- Teeth infections (–> maxillary sinus)
What are the CF of Sinusitis? (5 things)
- Fever / Headache
- Facial pressure + swelling
- Nasal congestion + discharge
- Loss of smell
- Tachycardia (systemic inf sign)
Whats the difference between Bac + Viral Sinusitis presentation?
- Viral: lasts less than 10 days + SELF LIMITING
- Bac: lasts more than 10 days
How is a diagnosis of Sinusitis made?
Clinically
What investigations should you do for sus Sinusitis not responding to treatment? (2 things)
- Nasal endoscopy
- CT
What are the management option for ACUTE Sinusitis? (3 things)
- Don’t give Abx for first 10 days (could be Viral –> self limiting)
If not improving after 10 days, probs Bac so:
- High dose steroidal nasal spray for 2 wks (mometasone) (for allergies)
- Delayed Abx prescription (PhenoxyMethylPenicillin) (to use if not getting better after 7 days)
What are the management options for Chronic Sinusitis? (3 things)
- Saline nasal irrigation
- Steroid nasal sprays / drops (mometasone / fluticasone)
- Functional Endoscopic Sinus Surgery (FESS)
