Causative & risk factors
The commonest cause of acute sinusitis is a viral infection. Bacterial or fungal infection can also cause sinusitis.
Other causes of acute sinusitis include allergies, nasal polyps, deviated nasal septum or spread through a tooth infection.
Several conditions increase the risk of developing acute sinusitis such as facial injury, cystic fibrosis, nasal tumors, smoking or a weak immune system.
Clinical presentation
The affected sinus is painful and tender. There is usually green/yellow coryza and the nostrils feel blocked. The sense of smell may be reduced. The patient may have a high fever. Additional symptoms include headache, toothache, halitosis and cough. The patient may feel tired, irritable and have a nasal speech with a sense of fullness in the ear.
Investigations
Investigations are not necessary to diagnose acute sinusitis, it is a clinical diagnosis. When the diagnosis is unclear, blood tests and X-rays of the paranasal sinuses may be performed.
Rarely specialized investigations like a nasal endoscopy or CT/MRI scans of the sinuses are suggested.
Treatment
Usually home care and symptomatic treatment is adequate to treat acute sinusitis. The patient is advised to rest, drink plenty of fluids and keep his head raised while sleeping to facilitate drainage of the sinuses. The nasal sinuses can be irrigated at home using certain devices.
Painkillers and decongestant drugs are prescribed for relief. Antibiotics and anti-fungal medications are needed only in case of bacterial or fungal sinusitis respectively.
Any underlying cause such as allergies, nasal tumors etc. must be treated appropriately.
Alternative treatment options like homoeopathy and ayurveda are also good treatment options for acute sinusitis.
