SINUSITIS

1. DEFINITION: It is an inflammation of the mucosal lining of one or more of the paranasal

sinuses including the ethmoid, maxillary , sphenoid, and frontal sinuses, due to viral,
bacterial or fungal infections or allergic reactions.

2. TYPES

 Acute
 Subacute
 Recurrent
 Chronic

3. RISK FACTORS

 Very young and very old people

 Women appear to be more at risk than men

 People in higher income and educational groups.

 Caucasians and African Americans are at more risk than Hispanic Americans.

4. CLINICAL FINDINGS (SIGNS) AND SYMPTOMS

They are, in many ways similar to those noted for other upper respiratory infections. Acute
sinusitis includes:

 Rhinorrhea (often yellow-green purulent)

 Midfacial or periorbital pain
 Pain in ( and often tenderness over) the affected area
 Malaise
 Congestion
 Fever
 Cheek swelling
 Conjunctival swelling
 Headache, maxillary toothache, altered sense of smell and taste , and nasal voice may be
present
 The presence of maxillary toothache, purulent secretion in the nasal meatus, and history of
colored nasal discharge may be an indicator of sinusitis
 5. INVESTIGATIONS

 Throat culture
 X-rays
 CT scan
 Endoscopy

6. DIFFERENTIAL DIAGNOSIS

 Periapical abscess

7. TREATMENT

For sinusitis caused by virus infection no antibiotic treatment is needed. Recommended treatment
includes:

 Pain and fever medications

 Steam inhalation
 Decongestants (phenylephrine, ephedrine or pseudoephedrine)

Acute sinus infection from bacteria is usually treated with antibiotic therapy.

 Penicillin or amoxicillin __________________________

In the penicillin allergic patient:

 Cefaclor __________________________ first choice treatment

 Clarithromycin __________________________
 Azithromycin __________________________
 Endoscopy sinus surgery (ESS)
 Computer- assisted sinus surgery
SURGERY can include:

Maxillary sinusotomy, ethmoidectomy or sphenoid sinusotomy

 8. POSSIBLE COMPLICATIONS:

Phycomicosis, aspergillosis and candidiasis

VOCABULARY

Lining: revestimiento, capa

Cheek: mejilla

Income: ingresos (money)