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Sinusitis

more about Sinusitis


  • A sinus is an open cavity. When one becomes infected, it is known as sinusitis.
  • The maxillary and frontal sinuses are the two main ones that tend to become infected.  The frontal sinuses are located in the lower part of the forehead just above the bridge of the nose.  The maxillary sinuses are located in the cheeks alongside the nose, and drain through the nose.
  • In addition, the ears drain fluid into the maxillary sinuses by way of the eustacian tube.  The eustacian tube may become blocked or inflamed from a sinus infection, resulting in pressure, pain, or fullness in the ears.
  • Sinusitis usually occurs after a viral infection (cold/runny nose) or after allergy symptoms begin, because the nasal tract tissue that drains the sinuses becomes swollen.  Consequently, the sinuses accumulate fluid and mucous, allowing bacteria to grow here, causing sinusitis.
  • Sinusitis is classified into acute sinusitis and chronic sinusitis.

  • Pain/pressure over the sinuses
  • Occasionally upper tooth pain
  • Pain/tenderness over the forehead
  • Ear pressure
  • Acute sinusitis:
    1. Cough, Bad breath, facial pain, periorbital swelling
    2. High fever
    3. Rhinorrhea
  • Chronic sinusitis (symptoms > 30 days):
    1. Low-grade fever, lack of energy, easy fatigued, poor appetite
    2. Nasal discharge

  • Predisposing:
    1. Viral rhinitis (cold)
    2. Allergies
    3. Nasoseptal deformity
    4. Large adenoids
    5. Cleft Palate
    6. Choanal Atresia
    7. Intranasal foreign body
    8. Cystic Fibrosis
    9. Immunodeficiency
    10. Diving, flying
    11. Dental problems
    12. Nasal polyps
  • Bacteria:
    1. Streptococcus pneumoniae
    2. HaemophilusInfluenza
    3. Moxarella catarrhalis
    4. Staphylococcus aureus

  • Trans-illumination (passing light through the sinuses) may show fluid collection; this is not helpful for patients younger than 10 years of age.
  • Sinus X-rays show mucosal thickening, air-fluid level, complete opacification
  • CAT scan of sinuses (more accurate than X-rays)
  • Cultures are not helpful unless done by needle inserted into a sinus (only done in extreme cases)

  • Oral antibiotics usually 10 to 14 days.  Commonly-used antibiotics include Ceftin and Augmentin.
  • Older antibiotics such as amoxicillin and erythromycin may be prescribed, but you should be aware they do not provide as broad a coverage as Ceftin and Augmentin.  Specifically, they are not as effective against Haemophilus Influenza.
  • Oral decongestants, such as pseudoephedrine, and nasal sprays, such as Afrin, for the first 3 days may be helpful (after 3 days "rebound" may occur and the decongestants may no longer be effective).
  • Take a warm shower twice a day, and "blow out excessive mucous."
  • Saline nasal sprays may be used multiple times during the day to loosen nasal secretions.
  • Chronic sinusitis: Treatment lasts 3-6 weeks.

  • If you or your child has a sinus condition that fails to respond to self-treatment in a week or two, or recurs repeatedly, consult your physician.

  • Tooth abscess
  • Mucormycosis
  • Sinus cancer




more about Sinusitis


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