Rhinosinusitis Flashcards
What is rhinosinusitis
symptomatic inflammation of nasal cavity and paranasal sinuses
how do you differentiate between acute and chronic
acute is <12 weeks of symptoms
chronic >12 weeks of symptoms
What is most common type of rhinosinusitis
acute viral
lasts 7-10 days
Caused by rhinovirus, influenza and parainfluenza
What is acute bacterial rhinosinusitis
very rare
can occur secondary as complication of viral infection
usually strep, pneumoniae, h.influenzae
How may someone present
nasal congestion/obstruction
Mucopurulent discharge
facial pain/ pressure
post nasal drip
What may be seen on examination
tender over sinuses
anterior rhinoscopy -
mucosal oedema
inferior turbinate hypertrophy
rhinorrhoea
nasal polyps in chronic
What are red flag symptoms associated with rhinosinusitis
Visual/orbital changes
focal neurology
blood stained
unilateral symptoms
How do you manage it acutely
analgesia
nasal saline irrigation
oral nasal decongestant - PHENYLEPHRINE for a week
topical intranasal glucocorticoids
antibiotics - high suspicion of bacterial cause
if unwell/risk of complications- Co- amoxiclav
How do you manage chronic rhinosinusitis
lifestyle advice - avoid triggers, smoking , steaming
nasal saline irrigation
Intranasal glucocorticoids up to 3 months
Refer to ENT if red flags or symptoms still occur `. 3 months or impact on QoL
What are some rare orbital complications
orbital/preseptal cellulitis
orbital abscess
What are some rare intracranial complications
meningitis
cavernous sinus thrombosis
