Alabama Nasal & Sinus Center

Alabama Nasal & Sinus Center

Sinusitis Guidelines 3

I'm back, gang!  Today, I  present here, for your education and enlightenment, our summary of the clinical practice guidelines for adult sinusitis as it applies to the patient.  The following will be in question/answer format.  

1.  What are the sinuses?
Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows (a) air from the nose to enter the sinuses and (b) mucus made in the sinuses to drain into the nose.
2.  What is sinusitis?
Sinusitis, also called rhinosinusitis, affects about 1 in 8 adults annually and generally occurs when viruses or bacteria infect the sinuses (often during a cold) and begin to multiply. Part of the body's reaction to the infection causes the sinus lining to swell, blocking the channels that drain the sinuses. This causes mucus and pus to fill up the nose and sinus cavities.
3.  How can I tell if I have acute sinusitis?
You have acute sinusitis when there has been up to 4 wk of cloudy or colored (not clear) drainage from the nose, plus one or both of the following: (a) a stuffy, congested, or blocked nose; (b) pain/ pressure/fullness in the face, head, or around the eyes.
4.  How can I tell if my sinusitis is caused by viruses or bacteria?
Acute viral sinusitis is likely if you have been sick less than 10 days and are not getting worse. Acute bacterial sinusitis is likely when you do not improve at all within 10 days of getting sick or when you get worse within 10 days after beginning to get better.

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5.  Why is it important to tell if my sinusitis is caused by bacteria?
Because sinusitis is treated differently according to cause, acute viral sinusitis does not benefit from antibiotics, but some patients with acute bacterial sinusitis may get better faster with an antibiotic.
6.  How long will it take before I feel better?
Most patients with ABRS feel better within 7 days, and by 15 days about 90% are cured or improved.
7.  Is there anything I can do for symptomatic relief?
There are several ways to relieve sinusitis symptoms that should be discussed with your doctor to decide which are best for you:
     a.  Acetaminophen or ibuprofen can relieve pain and fever.
     b. Saline irrigations, or washing out the nose with salt water, can relieve symptoms and remove mucus that is hard to blow out.
     c. Nasal steroid sprays can reduce symptoms after 15 days of use, but the benefit is small (about 14 people must use them to get 1 person better), and side effects include headache, nasal itching, and nose bleeds.
     d. Decongestants may help you breathe easier and can be taken as a nasal spray (for no more than 3 days in a row, to avoid worsening congestion) or dry mouth.

8.  Is there anything I should not do? (Boy, is that a loaded question!!!)
Antihistamines and oral steroid medicines should not be used routinely, because they have side effects and do not relieve symptoms.

Well, folks, that'll do 'er for today.  I'll answer some more hot boiling questions next week.   By the way, you can find me on Twitter @drLay.  Follow me for pithy comments and/or ask me questions which I may or may not answer in the blog.  Until next time, God bless you.

Sinusitis Guidelines 2
Sinusitis Guidelines 4