Sinusitis - Causes, Pathogenesis, Signs & Symptoms, Diagnosis, And Treatment

Video transcript :-

Humans have 4 pairs of air-filled cavities within their skull called paranasal sinuses. These sinuses are continuous with the nasal cavity, and they help lower the weight of the skull and filter, humidify, and warm the air.
Paranasal sinuses are lined by a ciliated pseudostratified epithelium, which contains mucus secreting goblet cells.
Sinusitis is defined as inflammation of the paranasal sinuses.
Since the nasal mucosa is simultaneously involved, sinusitis often co-exists with rhinitis.
Sinusitis is more common among females and is the fifth most common reason for antibiotic prescription.
Allergic, non-allergic, and viral insults produce inflammation in the nasal and sinus mucosae, which lead to sinus obstruction, and decreased ciliary function.
Due to this, the clearance of mucus from the sinuses reduces, which creates a good environment for pathogenic organisms to grow on.
The vast majority of the sinusitis cases are caused by viruses, especially rhinoviruses.
Others include corona viruses, influenza A and B, para influenza virus, and the respiratory syncytial virus.
Common bacterial causes include Hemophilus influenza, staphylococcus aureus, streptococcus pneumoniae, and pseudomonas aeruginosa.
Some common clinical features of sinusitis include the following.
Pain over the check, radiating to the frontal region or teeth, which increased with straining or bending down.
Redness of the nose, cheeks, or eyelids.
Tenderness to pressure over the floor of the frontal sinus.
Referred pain to the vertex, temple, or occiput.
Postnasal discharge.
Blocked nose.
Persistent coughing and pharyngeal irritation.
Facial pain.
Reduced sense of smell.
Fever, especially in bacterial sinusitis.
And ear fullness.
Physical examination findings include mucosal erythema, periorbital edema, tenderness over the sinuses, facial erythema, and transillumination of the sinuses.
Diagnosis of acute sinusitis is primarily clinical.
Management of sinusitis concerns 3 major aspects.
Providing adequate drainage of the sinuses with oral alpha-adrenergic vasoconstrictors such as pseudoephedrine and phenylephrine, or with topical vasoconstrictors such as oxymetazoline hydrochloride spray.
Antibiotic therapy, usually for 14 days.
Commonly used antibiotics include amoxicillin, clarithromycin, and azithromycin.
2nd line options are reserved for resistant cases and include co-amoxiclav, second or third generation cephalosporins, and fluoroquinolones.
And finally, supportive therapy, which includes adequate hydration, warm compresses, cessation of smoking, inhalation of warm water vapor, nutritional optimization, and adequate pain relief.

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