Acute and Chronic Sinusitis

Question 1

Definition of sinusitis

Answer 1

symptomatic inflammation of the paranasal sinuses.

Question 2

Explain difference between acute, recurrent acute and chronic sinusitis

Answer 2

Acute sinusitis - resolves completely within 12 weeks

Recurrent acute - four or more annual episodes

Chronic - symptoms last more than 12 weeks

Question 3

Causes of acute sinusitis - 3

Answer 3

Usually viral URTI

Can be bacterial

Also associated with asthma, allergic rhinitis, smoking, seasonal

Question 4

Causes of chronic sinusitis - 4

Answer 4

More likely to be inflammatory than infective, predisposing factors include:

• atopy
  -asthma
  -genetics
  smoking

Question 5

Presentation of acute sinusitis - 5

Answer 5

• follows a common cold usually
• nasal blockage
• nasal discharge
• facial pain/pressure
• tender on palpation of face

Question 6

Presentation of chronic sinusitis - 5

Answer 6

• nasal blockage
• nasal discharge
• facial pain/pressure
• tender on palpation of face
• may have nasal polyps or septal deviation on examination

Question 7

Differentials of sinusitis - 6

Answer 7

• URTI
• nasal foreign body
• turbinate hypertrophy
• migraine
• giant cell arteritis
• TMJ dysfunction

Question 8

Acute sinusitis management - 4

Answer 8

• if viral, it will self resolve
• if bacterial, oral antibiotics
• manage symptoms
• if symptoms persist, consider a nasal corticosteroid

Question 9

Chronic sinusitis management - 3

Answer 9

• avoid allergic triggers, stop smoking, good dental hygiene
• nasal irrigation with saline solution
• intranasal corticosteroids