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
1. surgically with sinus puncture and irrigation techniques.
2. 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