Common Cold and Rhinosinusitis

Question 1

What is the common cold?

Answer 1

viral infection of the URT

Question 2

What constitutes the URT?

Answer 2

• nasal cavity
• sinuses
• pharynx
• larynx

Question 3

How long does the common cold generally last?

Answer 3

it is self-limiting, usually lasts 7-10 days

Question 4

How is the common cold spread?

Answer 4

1) direct contact (lives on surfaces, transferred by hands to nasal membranes and eyes)
2) airborne through sneezing and coughing

Question 5

How is the common cold treated?

Answer 5

• rest and treat symptoms (ex. antipyretics)

Question 6

What treatments are not recommended for the common cold?

Answer 6

• antibiotics won’t work!
• no evidence that OTC drugs shorten illness, may relieve some symptoms but may also worsen some symptoms (ex. an antihistamine might dry up secretions, but this will worsen cough)

Question 7

What are manifestations of the common cold?

Answer 7

• dryness, stuffiness in nasopharynx
• excessive production of nasal secretions, tearing of eyes
• mucus membranes of URT red, swollen, bathed in secretions
• sore throat, hoarseness
• headache, malaise, fever, chills

Question 8

What is rhinosinusitis?

Answer 8

inflammation of the nasal passages and paranasal sinuses

Question 9

Which sinues are the paranasal sinuses?

Answer 9

• frontal
• ethmoid
• maxillary

Question 10

What are ostia?

Answer 10

narrow openings where sinuses drain into nasal cavity

Question 11

What is the pathology of rhinosinusitis?

Answer 11

• ostia obstructed by: allergic rhinitis, URT infection, nasal polyps, change in pressure (swimming)
• mucociliary clearance mechanism is impaired (normally keeps sinuses sterile)
• low oxygen area means micro-organisms (viruses, bacteria, both, fungi) can grow and IR is impaired
• infection results

Question 12

What are the manifestations of rhinosinusitis?

Answer 12

• similar to common cold
• sinus pain (can manifest as facial or tooth pain, can increase when bending over or coughing)
• purulent nasal drainage

Question 13

How is rhinosinusitis diagnosed?

Answer 13

• history and presentation
• transillumination of sinuses
• CT and MRI for chronic cases (expensive)

Question 14

How is rhinosinusitis treated?

Answer 14

• antibiotics for people with symptoms more than 7 days
• corticosteroids to decrease inflammation and improve drainage
• mucolytic agents to thin mucus and improve drainage
• symptom relief
• NS nasal spray, irrigation or mist humidification
• surgery in some chronic cases

Question 15

What are complications of rhinosinusitis?

Answer 15

1) intracranial complications
- facial swelling over affected sinus
- abnormal extraocular movement
- protrusion of the eyeball
- periorbital edema
- changes in mental status

2) orbital wall complications
- edema of eyelids
- orbital cellulitis
- subperiosteal abcess