Acute and Chronic Sinusitis (2)

Question 1

What is it?

How is it classified?

What are its causes?

What is a rare, but severe complication that occur here?

Answer 1

➊ Inflammation of paranasal sinuses

➋ • Acute - < 12 wks
• Chronic - > 12 wks

➌ • Infection - esp. following viral URTI
• Allergy
• Obstructed drainage e.g. nasal polyps, trauma, foreign body
• Smoking

➍ Pott’s puffy tumour - Forehead swelling due to frontal bone osteomyelitis with associated subperiosteal abscess

Question 2

How does acute sinusitis present?

How does chronic sinusitis present?
→ What is it commonly associated with?

Answer 2

➊ • Facial congestion, pain, or pressure
• Nasal congestion
• Headache
• Facial swelling
• Loss of smell
• Usually preceded by a Viral URTI

➋ Similar to acute sinusitis, but is usually painless
→ Nasal polyps

Question 3

How is it acute sinusitis managed?

How is chronic sinusitis managed?

Answer 3

➊ • If symptoms last < 10 days - Paracetamol, Nasal saline irrigation, Decongestants
• If symptoms last > 10 days - Nasal steroids, Delayed Abx (Phenoxymethylpenicillin)

➋ • Saline nasal irrigation
• Steroid nasal sprays and drops
• Functional endoscopic sinus surgery - removes obstructions e.g. polyps, and can open sinus up with balloons