Sinusitis

Question 1

What is sinusitis?

Answer 1

Inflammation of sinuses: frontal, maxillary, sphenoid or ethmoid

Question 2

What is acute sinusitis?

Answer 2

*Bacterial or viral infection of the sinuses lasting fewer than 4 weeks and resolving completely with the appropriate management

Question 3

What are the causes of sinusistis?

Answer 3

• Infective
• Allergies
• Smoking/other irritants
• asthma
• nasal dryness
• iatrogenic

Question 4

What is double sickening with sinusitis?

Answer 4

Typically evolves following a viral upper respiratory tract infection; the patient then reports an increase in symptoms =double sickening

Question 5

How can you assess sinusitis?

Answer 5

Frontal sinus:
>Press upward beneath medial side of supraorbital ridge

Ethmoidal sinus
>press medially against medial wall of orbit

Maxillay
>press against anterior wall, below inferior orbital margin

Question 6

What is the managemet of acute sinusitis?

Answer 6

*Analgesia + decongestants
*Antibiotics should not be prescribed in the majority of cases of acute sinusitis
>reserved for patients with persistent infective symptoms beyond 10 days

Question 7

What is chronic sinusitis?

Answer 7

Acute sinusitis but symptoms last for more than 12 weeks (3months)

Question 8

What is the presenation of sinusitis?

Answer 8

• Nasal blockage
• Rhinorrhoea
• Associated: hyposmia, facial/dental pressure
• Systemic upset
• Viral URTI 1st then get worse “double sickening”

Question 9

What is the management of chronic sinusitis?

Answer 9

• Eradicating persisting infection (antibiotics)
• Modulate triggers
• Reduce inflammation =nasal steroids