Sinusitis & chronic rhinosinusitis & polyps

Question 1

What are the features of acute sinusitis?

Answer 1

Facial pain - typically frontal pressure pain that is worse on bending forward
Nasal discharge - thick and purulent
Nasal obstruction

Question 2

What is the management for acute sinusitis?

Answer 2

Self limiting
Anlagesia

If symptoms >10 days = intranasal corticosteroids

Don’t give Abx, unless severe presentation:
Give phenoxymethylpenicillin
Give co-amoxiclav if systemically unwell

Question 3

What is double-sickening?

Answer 3

Where an initial viral sinusitis worsens due to a secondary bacterial infection

Question 4

What are the features of chronic rhinosinusitis?

Answer 4

Facial pain - frontal pressure pain that is worse on bending forward
Nasal discharge - clear if allergic or vasomotor. Thick and purulent if secondary infection
Nasal obstruction
Post-nasal drip
Hyposmia

Question 5

What is the management for chronic rhinosinusitis?

Answer 5

Avoid allergen
Intranasal corticosteroids
Nasal irrigation with saline solution

Question 6

What is Samter’s triad?

Answer 6

Asthma
Sinus inflammation + recurrent nasal polyps
Aspirin sensitivity

Question 7

What can be used to shrink nasal polyps?

Answer 7

Topical corticosteroids