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Diagnosis and Treatment
On physical examination, persons suffering sinusitis are usually found to have an elevation in body temperature, nasal discharge, and sinus tenderness. The diagnosis can be confirmed by X-rays of the sinuses and cultures of material obtained from within the sinuses.
Antibiotic treatment appropriate to the organism that is recovered in cultures is provided for a period of two weeks or longer.
Treatment of the disorder is directed primarily at overcoming the infecting organism by the use of systemic antibiotics such as penicillin and at encouraging drainage of the sinuses by the use of vasoconstricting nose drops and inhalations.
If the infection persists, the pus localized in any individual sinus may need to be removed by means of a minor surgical procedure known as lavage, in which the maxillary or sphenoidal sinuses are irrigated with water or a saline solution.
Chronic sinusitis may follow repeated or neglected attacks of acute sinusitis, particularly if there is impaired nasal breathing or drainage from intranasal obstruction.
The symptoms of chronic sinusitis are a tendency to colds, purulent nasal discharge, obstructed breathing, loss of smell, and sometimes headache.
Pain is not a feature of chronic sinusitis. If antibiotic therapy or repeated lavage do not alleviate the condition, surgery may be necessary.
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