Sinusitis is one of the most common diagnosed disease.
Sinus infections happen, when fluid builds up in the air-filled pockets in the face called sinuses, which allows germs to grow.
Viruses cause most sinus infections. In some cases, it is caused by bacteria.
Sinusitis is Inflammation of the nose and the paranasal sinuses, characterised by two or more of the following symptoms:
Nasal obstruction or congestion, "stuffy", plugged feeling in the nose.
Rhinorrhea, excessive discharge of mucus from the nose.
Excessive discharge can move down the back of the throat, often causing cough. It is called Post-nasal drip.
Facial pain or pressure; reduction or loss of smell. Sometimes bad breath, called halitosis.
Sometimes these symptoms are accompanied by:
Fever or malaise.
• Toothache (upper teeth).
Symptoms commonly lasting less than 12 weeks.
If Patients has acute facial pain or headache, but no other nasal symptoms are highly unlikely to have sinusitis. Sinusitis also called rhinosinusitis.
If rhinosinusitis lasts less then 10 days, more likely it is caused viruses.
If it lasts more then 10 days higher chances of bacterial infection.
If it lasts more then 12 weeks, it is called chronic rhinosinusitis.
Several factors can increase your risk of getting a sinus infection:
A previous cold,
Seasonal allergies,
Smoking and exposure to secondhand smoke,
Structural problems within the sinuses.
For sinusitis lasting more than 12 weeks, a CT scan is recommended.
Nasal endoscopy and clinical symptoms are also used to make a positive diagnosis.
Treatment:
for most cases of sinusitis include rest and drinking enough water to thin the mucus.
Nasal steroids and nasal saline irrigation are the most common recommendations in guidelines. Antibiotics are not recommended for most cases. Antihistamines are not a recommendation unless there is a clear allergic component as they potentially thicken nasal secretions.
When Antibiotics are needed: The American Academy of Otolaryngology Adult Sinusitis 2015 updated guideline recommends amoxicillin with or without clavulanate in adults as first-line therapy for a period of 5 to 10 days in most adults.
For patients allergic to penicillin, a third-generation cephalosporin plus clindamycin or doxycycline could be therapeutic possibilities.
Treatment for chronic sinusitis:
Nasal steroids should be used with or without nasal saline irrigation. The treatment should last at least eight to 12 weeks with proper usage.
Nasal saline irrigation is inferior to nasal steroids. However, nasal saline irrigation can serve as a useful adjunct. High volume nasal saline irrigation was found to be more effective than low-volume nasal spray techniques.
Antibiotics can be given for an extended period of three weeks. However, there is no consensus on their routine use in chronic sinusitis, nor is their consensus on antibiotic selection.
Complications are rare, occurring in about 1 out of every 1000 cases. Sinus infections may spread to the orbit, bone, or intracranial cavities.
Urgent referral is required if complications of rhinosinusitis are suspected—such as orbital sepsis or intracranial sepsis.
Functional endoscopic sinus surgery can be considered for patients who fail medical management. In more complicated cases, it can serve as an adjunct to medical management. The goal of this surgery is to relieve obstructions, restore drainage and mucociliary clearance, and to ventilate the sinuses.

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