Sinusitis refers to inflammation of the mucosal lining of the nose and sinuses.
Sinuses are air-filled spaces in the bones of the face and skull. There are 4 pairs of sinuses- the frontal sinuses (in the forehead), and maxillary sinuses (below the eyes), the ethmoid sinuses (between the eyes) and the sphenoid sinuses( at the back of the nose, in the centre of the head).
Major symptoms of sinusitis are-
Nasal congestion/ obstruction
A discoloured (yellow/ green/brown) nasal discharge or postnasal drip
Facial pain/ fullness/ pressure
Alteration in the sense of smell
Minor symptoms of sinusitis are-
Headache, fever, halitosis, fatigue, toothache, cough, earache, blocked ears
Acute sinusitis usually follows a viral upper respiratory tract infection (URTI), e.g. influenza, the common cold, and lasts less than 4 weeks
If symptoms last for more than 3 months, this is referred to as chronic sinusitis
Children have 6 to 8 viral URTIs each year; about 5% to 13% result in secondary bacterial infection of the sinuses
Viral infections are the cause of approximately 80% of bacterial sinus infections. Allergic inflammation is responsible for most of the remaining cases.
DIAGNOSIS
Sinusitis is diagnosed by taking a history, and by examining the nasal passages. X-rays and CT scans are not necessary until medical treatment has failed, (and surgery is indicated).
TREATMENT
1] Antibiotics- e.g. Augmentin, Orelox for 5-10 days initially
2] Steroids- Prednisone for 5 days
3] Analgesics (painkillers)- Myprodol, Paracetamol
Adjuvant treatments
–decongestant nasal sprays, e.g. Iliadin- to be used for a maximum of 5-7 days
–nasal steroid sprays– e.g. Flixonase, Avamys – are best for patients with allergic rhinitis/ hayfever- can be used long term, i.e. for several months continuously.
–steam inhalations– with or without menthol
–saline nasal irrigation (see post on saline douches)
–antihistamines e.g. Xyzal, Deselex
–mucolytic agents e.g. ACC 200
Please note-
Ultrasound and physiotherapy are of no known benefit in sinusitis
SURGERY-i.e. FESS or Functional Endoscopic Sinus Surgery
Surgery is only indicated if symptoms persist in spite of maximal medical therapy. Prior to undertaking FESS, a CT scan must be done to ascertain the extent of the sinusitis.
Please read the post on FESS for further information
YOUR CONSULTATION
If you think you suffer from sinusitis, and would like help, please book an appointment by calling 031 201 3118.
A detailed history of your problem will be taken. This will be followed by a complete examination of the ears, nose and throat, including nasal endoscopy.
You will receive a clear explanation of your problem, and the appropriate treatment will be prescribed according to best ENT specialist practice guidelines.
A follow-up visit will be scheduled to assess your progress.
If your symptoms persist, then further investigations will be requested, e.g. a CT scan of the sinuses