This document provides information on the clinical management of sinusitis. It defines sinusitis as the inflammation of the paranasal sinuses and discusses its causes such as viruses, bacteria, fungi, allergens, and structural abnormalities. The document outlines the different types of sinusitis and their associated symptoms. It also discusses the diagnosis, complications, and homoeopathic and general management of sinusitis.

1. Clinical tips for the
Management of Sinusitis

2.  Sinusitis is the inflammation or swelling of the tissue
lining the paranasal sinuses
 It is also called rhinosinusitis
Definition
When sinuses become blocked and filled with fluid, organisms such as bacteria,
viruses and fungi can proliferate in them CAUSING SINUSITIS
 Sinuses are a four pairs of air filled cavities within the facial
bones
 They are lined with mucous membrane and trap dirt particles
and bacteria

3. Causes of Sinusitis
•Viral such as common cold, Bacterial or Fungal
•These cause swelling of the lining of the sinuses blocking the
opening
Infection
•Allergens such as Pollen, Irritants such as Chemical sprays,
smoke
•Exposure to these can inflame lining of the sinuses
Allergy
•Enlarged Adenoids, Nasal polyps, Deviated nasal septum
•These can impede the drainage of sinuses into the nasal cavity
Structural abnormalities
•Diseases such as Cystic Fibrosis
•Exposure to irritants such as cigarette smoke
Predisposing factors

4. Clinical types
Sudden onset
of runny,
blocked nose
,with facial
pain lasting
upto 2-4weeks
Symptoms of
sinusitis
lasting for 4-8
weeks
Symptoms
lasting for
more than 8
weeks
Several
attacks within
a year
Acute sinusitis Sub-acute Sinusitis Chronic sinusitis Recurrent Sinusitis

5. Symptoms of Sinusitis
Acute Sinusitis
 Nasal blockage
 Nasal discharge
 Facial
pain/tenderness
 Loss of smell
 Cough
 Fever
 Bad
breath(halitosis)
 Fatigue
 Dental pain
 Facial pain/ congestion/
sensation of fullness
 Nasal obstruction
 Fever
 Discoloured nasal/post
nasal discharge
 Headache
 Bad breath
 Fatigue
 Dental pai
Chronic Sinusitis

6. Diagnosis
 Physical examination-Facial Tenderness may be
present
 X- ray( paranasal sinus radiography) –Normal
sinuses look black on x-ray, in sinusitis a dense
white /grey shadow indicating an air-fluid level
 Mucous culture may reveal the causative
organism
 Nasal endoscopy/CT Scan/MRI may also be used
 Allergy tests to identify specific allergens

7. Complications
•Meningitis, Brain abscess
•Spread of infection to the
orbit can cause reduced/lost
vision, orbital cellulitis
•It may trigger asthma attacks
•Facial osteomylitis
•Cavernous sinus thrombosis
Though rare,
Chronic
sinusitis can
cause some
complications

8. Homoeopathic treatment is effective in
Acute and Chronic Sinusitis
In Acute phase, totality of symptoms must be
used as a guide to choosing the remedy,
exciting cause should also be considered
During the disease free period the a well
chosen constitutional, anti-miasmatic remedy
goes a long way in correcting the dyscrasia
Homoeopathic Management

9. Remedy Indications
ARSENICUM ALBUM Throbbing and burning pains in the sinuses< by light, noise, movement, after midnight, > by
lying quietly in a dark room with the head raised on pillows and warmth application. Nausea and
vomiting concurrent with sinusitis. Great thirst, desire for drink in frequent sips, rather than
gulps
ARSENICUM IODATUM Tubercular Diathesis, Dull, heavy headache, < occiput Eyeballs feel heavy, Foul otorrhœa,
Persistent, but unsatisfactory sneezing, Nose drips water, hot , green, acrid, reddens upper
lip, Coryza; with dyspnœa , post-nasal catarrh, Colds with hunger, Aching malar bones
ARUNDO Deep seated pain in sides of head with painful roots of hair, Coryza accompanied by marked
itching in the nostril & roof of the nose, Temporary loss of smell.
BELLADONNA Throbbing frontal headache < by jarring, touch, bending forward, or motion of the eyes and >
pressure and in semi erect posture, Pain appears suddenly , then disappears temporarily, only to
repeat the process of coming and going ,ailments from least exposure to cold.
ECHINAECIA Foul smelling discharges, membranous formations protruding, nose feels stopped up
ELAPS CORALLINES In chronic cases, with chronic nasal catarrah with fetid odour & greenish crusts, Pain at the root
of nose , Nose blocked, < cold drinks, wet weather, eating fruits
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10. Remedy Indications
EUCALYPTUS Rheumatic-Hydrogenoid constitution, Stuffed-up sensation, thin, watery coryza, nose does not
stop running, tightness across nose bridge, Chronic catarrhal, purulent and fetid discharge,
Ethmoid and frontal sinus involved. Dull congestive headache
FAVUS Pain in Frontal and Maxillary sinuses, Dry with dry crust, Discharge of greenish pus < Morning, >
in morning after sneezing
FORMICA RUFA Marked deterrent on the formation of Nasal Polyp, Blocked sensation of NASAL POLYP
HEDERA HELIX Pain of the Ethmoidal and Frontal sinus. Inflammation of the frontal sinuses with headache.
Nasal discharge < Hot room
HEPAR SULPH Rarely indicated at the beginning of a sinusitis. Nasal discharge is thick and yellow. Nostrils
become very sore from the acrid discharge, and the nasal passages become sensitive to cold air
HIPPOZAENIUM Discharge acrid, corroding, bloody, offensive. Papules and ulceration in frontal sinus and
pharynx
HYDRASTIS Chronic sinusitis where there is thick, tenacious yellow secretion from posterior nares to throat.
Dull, pressive frontal pain, especially associated with constipation. Also useful in acute cases.
Sinusitis after suppressed coryza
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11. Remedy Indications
INFLUENZINUM Polysinusitis with history of Influenza
IODUM Pain at the root of the nose, with nasal blockage
KALI BICHROMICUM Syphilitic or Scrofulous background. More adapted to sub-acute rather than acute violent
stages, Pressure and pain at root of nose, and sticking pain in nose. Septum ulcerated, round
ulcer. Fetid smell. Discharge thick, ropy, and greenish-yellow. Tough, elastic plugs from nose,
leave a raw surface, Inflammation extends to frontal sinuses, with distress and fullness at root
of nose, Dropping from posterior nares, Loss of smell. Hawking, Inability to breathe through
nose, Dryness, Coryza, with obstruction of nose, Violent sneezing. Profuse, watery nasal
discharge, Chronic inflammation of frontal sinus with stopped-up sensation , Fontal pain usually
over one eye
KALI IODATUM Syphilitic background, incipient organic changes. Tip of nose red; profuse, acrid, hot, watery,
thin discharge. Ozæna, with perforated septum. Sneezing. Nasal catarrh, involving frontal sinus.
Stuffiness and dryness of nose, without discharge. Profuse, greenish, irritating discharges.
Intense pain over eyes and root of nose
LACHESIS Severe frontal headache after cessation of nasal discharge. Pain > after flow begins. Bloody
discharge
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12. Remedy Indications
LUFFA OPERCULATA Acute or chronic inflammation . Dryness of the nasal mucous membrane with adhering crust
formation,< confined air, > Fresh air of the outside
MENTHOLUM Frontal headache, pain over frontal sinus, descends to eyeballs. Supra orbital pain over left eye.
Pain in face above zygoma with numbness. Pain in eyeballs. Coryza with post-nasal dripping.
Cold sensation in nose. Eustachian tubes feel blocked and some deafness. Short, dry cough,
worse smoking. Asthmatic breathing, with congestive headache
MERCURIUS SOLUBILIS Thick, greenish, offensive, acrid nasal discharge. Sensitive to both heat and cold. Profuse
perspiration without relief. Tongue is flabby with imprint of teeth, profuse salivation, and foul
breath.
NAT MUR Suitable for early stages with symptoms like sneezing, loss of smell and a blocked sensation
with watery discharge. Throbbing frontal headache
NUX VOMICA Treats symptoms of sinusitis where sneezing and runny nose are frequent by day, but nose
stopped at night, and it is not uncommon for a patient to wake up with complaints around 3-4
a.m,<in warm room, > in cold air
PENTHORUM Constant wet feeling in nose with no amount of blowing will relieve. Discharge thick, pus-like,
streaked with blood. Post nasal cattarh of puberty
PENICILLINUM Right Frontal Sinusitis. Right sided frontal headache. Discharge is yellow, thick, < Humid cold
weather, > Warmth
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13. Remedy Indications
PNEUMOCOCCINUM Pain on Left Frontal Sinuses, Sub-orbital frontal pain < Humid weather, > Open air
PULSATILLA Headache <in a warm room and better in open air, cold application & pressure. Pain rapidly
shifting from one part to another. The nasal discharge is thick, bland & yellowish-green. Marked
thirstlessness.
PYROGEN Pansinusitis with fever, headache, Mostly the sphenoidal sinus is involved
SABADILLA Spasmodic sneezing, with running nose. Coryza, with severe frontal pains and redness of eyes
and lachrymation. Copious, watery, nasal discharge. Sensitive smell. Pain in alternate sides of
forehead. Unilateral head pains. Tongue feels burning sensation
SILLICEA Indicated for chronic sinusitis, chronic congestion accompanied by headache that tends to be
worse in the right eye. Pain is < by cold, movement, light, noise, and mental concentration (such
as when studying), uncovering the head but > by wrapping warmly and pressure
SPIGELIA Forepart of nose always dry, discharge through posterior nares chronic catarrh, with post-nasal
dropping of bland mucus. Fetor oris. Left supra-orbital or occipital pain; boring
STICTA PULMONALIA Feeling of fullness at the root of nose. Dryness of nasal membrane, constant need to blow the
nose, but no discharge. Dry scabs, especially in evening & night. Dull headache, with dull heavy
pressure in forehead & root of nose before discharges appear
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14.  Eucalyptus Q
 Ocimum sanctum Q
 Hydrastis Q
Mother tinctures used for inhalation
Steam inhalation using water medicated with
15-20 drops, 2-3 times daily.

15.  Steam inhalation with water medicated with mother
tinctures like Hydrastis, ocimum sanc & Eucayptus
 Use a humidifier in the room
 Drinking lots of fluids helps to keep the mucus thin,
preventing their blockage
 Jal and Sutra Neti , the yogic technique of flushing out
the nasal passages & sinuses using salt water and thread
may help
 Use a nasal saline solution. While they don't contain
medicine, they can help keep your nasal passages moist
 Flush out the sinuses. Nasal irrigation with salt water
can clear out mucus (and other debris) and keep sinuses
moist
 Putting a warm, wet towel on the face may help relieve
some of the pressure
General Measures

16.  Dr Ashok Sharma, CMO
 Dr Jithesh T.K, C.M.O
 Dr Prasad Mahajan, CMO
 Dr Pradip Kumar Roy, S.M.O
 Dr Ram Kumar, SMO
 Dr Malay Kumar Ray, M.O
 Dr Cheshta Nagrath, M.O
Dr Deepti Chawla
C.M.O, Dte. of AYUSH
Contributors: Compiled & Edited by: