Contents
1. Etiology
Sinusitis – inflammation of paranasal sinuses. Main causes:
- Infectious (90% cases):
- Viruses (rhinoviruses, adenoviruses)
- Bacteria (S. pneumoniae, H. influenzae)
- Fungi (rare, in immunocompromised)
- Non-infectious:
- Allergic rhinosinusitis
- Vasomotor rhinitis
- Anatomical abnormalities (deviated septum, polyps)
Risk factors: URI, allergies, smoking, swimming, dental problems.
2. Symptoms
Acute sinusitis (<4 weeks duration):
- Nasal congestion
- Thick yellow-green discharge
- Sinus pain/pressure
- Reduced smell
- Cough (especially nocturnal)
- Fever (with bacterial infection)
Chronic sinusitis (>12 weeks):
- Persistent congestion
- Headache
- Mucopurulent discharge
- Fatigue
3. Diagnosis
- History and physical exam:
- Characteristic complaints
- Sinus tenderness
- Instrumental methods:
- Anterior rhinoscopy
- Nasal endoscopy
- X-ray (limited value)
- CT (gold standard for chronic sinusitis)
- Ultrasound (alternative in pregnancy)
- Lab tests:
- CBC
- Bacterial culture (for complications)
4. Treatment
Acute viral sinusitis (<10 days duration):
- Saline irrigation
- Topical decongestants (not >5-7 days)
- Analgesics if needed
Acute bacterial sinusitis:
- Antibiotics (amoxicillin/clavulanate 1st line)
- Topical corticosteroids
- Irrigation therapy
Chronic sinusitis:
- Intranasal corticosteroids
- Long-term antibiotics (if needed)
- Surgical treatment (FESS)
5. Prevention
- Prompt treatment of URI and allergies
- Air humidification
- Smoking cessation
- Regular nasal hygiene
- Vaccination (flu, pneumococcus)
6. When to seek medical help?
- Symptoms >10 days without improvement
- High fever (>39°C)
- Severe headache
- Periorbital edema
- Visual disturbances
- Meningeal signs
7. How to prevent sinusitis?
- Dental health control
- Regular hand washing
- Allergen avoidance
- Proper nose blowing
- Immune system support
