Many individuals suffer from acute sinusitis every year. Although this condition can become a chronic one the majority of patients recover with treatment and have few complications.

What is acute sinusitis?
This is an inflammatory condition of the mucous membrane lining the Para nasal sinuses. Sinuses are air-filled, hollow spaces or cavities within the facial bones around the nose. Inflammation causes obstruction and interferes with normal drainage of mucus.

What causes acute sinusitis?
Viruses and bacteria are most often responsible for acute sinusitis. A viral, bacterial or fungal infection of the upper respiratory tract frequently results in sinusitis in susceptible individuals. Other conditions can make an individual susceptible to acute sinusitis. These include allergies, deviated nasal septum (the wall between the nostrils is crooked) and nasal polyps (growths of tissue in the nose).

What are the signs and symptoms of acute sinusitis?
These may vary from one individual to another but include the following:

• Yellow or greenish nasal discharge
• Congestion that makes it difficult for you to breathe through your nose

• Pain, tenderness and swelling around your eyes, cheeks, nose or forehead
• Headache
• Fever, chills
• Cough
• Reduced sense of smell or taste
• Bad breath
• Ear pain

Prevention
If you reduce your risk of upper respiratory infection you can lessen your chances of developing acute sinusitis. You can do this by minimizing close contact with people who have colds and washing your hands frequently with soap and water.

Do not smoke. Tobacco can cause irritation an inflammation of the lining of the sinuses and nose.
Avoid polluted air.

How is the diagnosis made?
In most cases the clinical findings are so classic that X-rays are not needed. If the diagnosis is unclear, X-ray of the sinuses may be needed. Your doctor may arrange for other tests if required.

Treatment
Most people with acute sinusitis (60-80%) get better without antibiotics. The person with acute sinusitis for the first time may be treated with decongestants and pain relievers. Individuals with sinusitis should drink adequate amounts of fluids (eight glasses of fluid a day). They should avoid alcohol as this may worsen the swelling of the lining of the sinuses and nose.

Applications of ice packs over the sinuses can be helpful.

Nasal sprays do not provide adequate delivery of medication to treat acute sinusitis. Nose drops should not be used for more than seven days because of the risk of rebound oedema, which can worsen your symptoms.

If symptoms persist for over three days, or if there is evidence of superinfection, your doctor may prescribe an appropriate antibiotic.

Prognosis
A single attack of sinusitis does not predispose to recurrences unless contributing underlying abnormalities remain uncorrected. The immediate prognosis is very good in the majority of cases with acute sinusitis.

Complications are very rare. Sinusitis can aggravate the symptoms of asthma. Serious complications of acute sinusitis include meningitis -infection of the lining of the brain, visual problems and blood vessels problems. Fortunately these are very rare.

Conclusion
Acute sinusitis affects many individuals and in the majority of cases the predisposing condition is the common cold. Most individuals respond to treatment and only a small minority of patients require antibiotics as part of their treatment. Individuals with recurrent sinusitis require a thorough investigation and should see a qualified doctor.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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