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.
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Symptoms predictive of an acute sinusitis infection include:
Other associated signs and symptoms of sinusitis include:
Signs and symptoms indicating urgency or complications of sinusitis are:
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.
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.
Treatment of sinusitis includes both palliative care and medical management. The following encompass palliative care:
Medical treatment of sinusitis entails using the following:
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