Sinusitis

Sinusitis, also known as rhinosinusitis and commonly known as a sinus infection, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure, loss of smell, or fever. Sinusitis is a condition that affects both children and adults. It is caused by a combination of environmental and health factors. It can occur in individuals with allergies, exposure to environmental irritants, structural abnormalities of the nasal cavity and sinuses and poor immune function. Most cases are caused by a viral infection. Recurrent episodes are more likely in people with asthma, cystic fibrosis, and immunodeficiency. A diagnosis of sinusitis is based on the symptoms and their duration along with signs of disease identified by endoscopic and/or radiologic criteria. Sinusitis is classified into acute sinusitis, subacute sinusitis, and chronic sinusitis. In acute sinusitis, symptoms last for less than four weeks, and in subacute sinusitis, they last between 4 and 12 weeks. In chronic sinusitis, symptoms must be present for at least 12 weeks. In the initial evaluation of sinusitis an otolaryngologist, also known as an Ear, Nose and Throat (ENT) doctor, may confirm sinusitis using nasal endoscopy. Diagnostic imaging is not usually needed in the acute stage unless complications are suspected. In chronic cases, confirmatory testing is recommended by use of computed tomography. Prevention of sinusitis focuses on regular hand washing, staying up-to-date on vaccinations, and avoiding smoking. Analgesics such as naproxen, nasal steroids, and nasal irrigation may be used to help with symptoms. Recommended initial treatment for acute sinusitis is watchful waiting. If symptoms do not improve in 7–10 days or worsen, then an antibiotic may be implemented or changed. In those in whom antibiotics are indicated, either amoxicillin or amoxicillin/clavulanate is recommended...