Acute and Chronic Sinusitis

Question 1

What is Sinusitis?

Answer 1

Inflammation of the mucus membranes of the paranasal sinuses

Question 2

What are the most common organisms that cause acute sinusitis?

Answer 2

• Streptococcus Pneumoniae
• Haemophilius Influenza
• Rhinovirus

Question 3

What is the difference between acute and chronic sinusitis?

Answer 3

Acute => clinical symptoms present for ≤ 4 weeks

Chronic => clinical symptoms present for ≥ 12 weeks

Question 4

What are the risk factors of Acute Sinusitis?

Answer 4

• Smoking
• Swimming
• Nasal obstruction
• Recent local infection

Question 5

What are the clinical features of Acute Sinusitis?

Answer 5

• Facial pain => frontal pressure, worse when bending down
• Nasal discharge => clear and purulent
• Nasal obstruction

Question 6

What are the investigations in suspected Sinusitis?

Answer 6

=> Usually a clinical diagnosis

=> Imaging of Sinuses

• CT
• X ray
• MRI

=> Sinus culture

=> Nasal endoscopy

Question 7

What is the management of Acute Sinusitis?

Answer 7

• Analgesia
• Intranasal decongestants

=> If symptoms present for longer than 10 days:
Intranasal Corticosteroids

=> Severe presentations require Oral Antibiotics:
- Phenoxymethylpenicillin

Question 8

What is the management of Chronic Sinusitis?

Answer 8

=> Antibiotics
- Amoxicillin or Cefuroxime

=> Nasal irrigations

=> Intanasal corticosteroids

=> If medical therapy fails:
- Endoscopic sinus surgery