Acute Sinusitis

this is a ppt of guidelines for acute sinusitis

1. ACUTE SINUSITIS DR RAJASHRI MANE

2. Sinusitis is characterized by inflammation of the lining of the paranasal sinuses. Rhinosinusitis is now the preferred term  

3. Acute Sinusitis -Symptoms A blocked nose Postnasal discharge Pain over cheek and radiating to frontal region or teeth, increasing with straining or bending down Facial pain Referred pain to the vertex, temple, or occiput Redness of nose, cheeks, or eyelids Persistent coughing or pharyngeal irritation Hyposmia

4. Signs Purulent nasal secretions Purulent posterior pharyngeal secretions Mucosal erythema Periorbital edema Tenderness overlying sinuses Tenderness to pressure over the floor of the frontal sinus immediately above the inner canthus Air-fluid levels on transillumination of the sinuses (60% reproducibility rate for assessing maxillary sinus disease) Facial erythema

5. Investigations X Ray PNS Water’s view Diagnostic Nasal Endoscopy CT PNS

6. Culture Cultures -- not routinely obtained, obtained in the following cases: Patients in intensive care or immunocompromise Children not responding to appropriate medical management Complications of sinusitis. In adults, cultures are directed at the middle meatus . Aspiration of the sinus by direct antral puncture is the only accurate way to obtain a culture

7. Treatment of acute sinusitis 1. Adequate drainage of the involved sinus 2. appropriate systemic treatment of the likely bacterial pathogens.

8. Drainage can be achieved surgically with sinus puncture and irrigation techniques. Options for medical drainage are as follows: A) Oral alpha-adrenergic vasoconstrictors ( eg , pseudoephedrine, and phenylephrine ) for 10-14 days B) Topical vasoconstrictors ( eg , oxymetazoline hydrochloride) for a maximum of 3-5 days

9. Antibiotic treatment Given for 14 days. Usual first-line therapy is Amoxicillin , Azithromycin

10. Symptomatic or adjunctive therapies Humidification/vaporizer Warm compresses Adequate hydration Smoking cessation Balanced nutrition Nonnarcotic analgesia

11. THANK YOU