What is sinusitis and what are the symptoms?
Sinusitis is an infection of the paranasal sinuses that may be bacterial (mainly Streptococcus pneumoniae an Haemophilus influenzae) or occasionally fungal. It is most commonly associated with an upper respiratory tract infection and can occur with severe asthma. Symptoms
include frontal headache, purulent rhinorrhoea (nasal discharge), facial pain with tenderness and fever. It can be confused with a variety of other conditions such as migraine, trigeminal neuralgia, and cranial arteritis.
Treatment of sinusitis
Treatment for a bacterial sinusitis includes nasal decongestants, e.g. xylomethazoline, broad-spectrum antibiotics, e.g. co-amoxiclav (Augmentin) because H. influenzae can be resistant to amoxicillin, anti-inflammatory therapy with topical corticosteroids such as fluticasone propionate nasal spray to reduce mucosal swelling, and steam inhalations.
If the symptoms of sinusitis are recurrent or, complications such as orbital cellulitis arise, then an ENT opinion is appropriate and a CT scan of the paranasal sinuses is undertaken. Plain sinus X-rays are now rarely used to image the sinuses.
CT scan of the sinuses or an MRI scan can demonstrate soft tissue planes.
Functional endoscopic sinus surgery (FESS) is used for ventilation and drainage of the sinuses.
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