Sinusitis Treatment, Drugs, Causes, Symptoms, and Diagnosis

Sinusitis is the symptomatic inflammation of paranasal sinuses occurring as a result of impaired drainage and retention of secretions. Sinusitis is broadly classified into acute and chronic sinusitis. In acute sinusitis, symptoms last less than eight weeks. Chronic sinusitis is characterized by three to four episodes annually or failure to respond to medical therapy.


Sinusitis Drugs

  • Amoxicillin
  • Septrim
  • Decongestants
  • Acetaminophen
  • Aspirin
  • NSAIDS
  • Acetaminophen-codeine


Sinusitis Symptoms

Symptoms predictive of an acute sinusitis infection include:

  • Preceding upper respiratory tract infection symptoms, particularly if seemed to be spontaneously resolving with acute return of symptoms
  • History of colored nasal discharge
  • Unilateral facial pain that is worse with bending forward or with a cough or sneezing
  • Maxillary toothache
  • Poor response to antibiotics

Other associated signs and symptoms of sinusitis include:

  • Headache
  • Retro-orbital pain
  • Otalgia
  • Hyposmia
  • Halitosis
  • Chronic cough
  • Edematous nasal mucosa
  • Nasal obstruction or polyps

Signs and symptoms indicating urgency or complications of sinusitis are:

  • Orbital pain
  • Periorbital swelling or erythema
  • Visual disturbances, especially diplopia
  • Abnormal extra-ocular movements
  • Facial swelling or erythema


Sinusitis Causes

Sinusitis is caused by disturbances of airflow into the sinuses and drainage of secretions out of the sinuses. The causes may be infectious or due to allergic reactions. The primary causative agents are usually bacteria, such as S. pneumoniae, H. influenzae (nontypable), M. catarrhalis, and B-hemolytic streptococci. An acute viral URTI often precipitates the infection. Virus and fungi, such as Aspergillus are also causative agents. Causes of sinusitis include the following.

  • Viral upper respiratory tract infection
  • Extreme age
  • Anatomical abnormalities: tonsillar and adenoid hypertrophy, deviated septum, nasal polyps, cleft palate
  • Nasotracheal intubation
  • Dental infections and procedures
  • Trauma
  • Immunodeficiency & HIV disease


Sinusitis Diagnosis

The diagnosis of sinusitis is made by taking a detailed, thorough history and proper examination. Establish signs and symptoms in keeping with sinusitis. For accurate visualization of the paranasal sinuses, nasolaryngoscopy or maxillary sinuscopy are employed. Alternatively, plain sinus radiographs, single Waters view, may be sufficient to make a diagnosis of sinusitis, especially when only 2-3 of associated signs and symptoms are present. In the plain film, look for the presence of air-fluid levels, sinus opacity, mucosal thickening (more than 6mm in children or over 8mm in adults). The use of limited coronal CT of sinuses is most useful in the diagnosis of chronic sinusitis.


Sinusitis Treatment

Treatment of sinusitis includes both palliative care and medical management. The following encompass palliative care:

  • Adequate hydration (8-10 glasses water daily);
  • Steam inhalation for 20-30 minutes three times a day efficiently produces nasal vasoconstriction and promotes drainage;
  • Saline irrigation or saline nose drops promote drainage;
  • Sleep with head of bed elevated;
  • Avoid exposure to tobacco smoke, fumes

Medical treatment of sinusitis entails using the following:

  • Antibiotics such as Amoxicillin or Septrin for 10-14days in acute sinusitis and for 4-6 week in chronic sinusitis
  • Decongestants are useful for first 3-5 days
  • Analgesics such as acetaminophen, aspirin, NSAIDS, acetaminophen-codeine
  • Functional endoscopic sinus surgery (FESS) is used should three weeks of medical therapy fail