Treating acute sinusitis

Abstract

Infections in the nose involve the sinuses because the lining of the nose and the paranasal sinuses is continuous. The major sinuses drain through a common tract – the ostiomeatal complex, which is located under the middle turbinate. Acute sinusitis usually follows a cold and presents with nasal obstruction, facial pain, dental pain, purulent rhinorrhoea, sinus tenderness and in some cases fever and malaise. The diagnosis is made on the history, the patient’s lack of response to topical decongestants and on finding pus in the nose with associated sinus tenderness. Treatment consists of combining topical or systemic decongestants with saline irrigations and an antibiotic, usually amoxycillin. Referral to a specialist should be considered if patients fail to respond to second line antibiotic therapy and for those who get recurrent episodes of sinusitis.