Diagnosis and Treatment of Acute Sinusitus

Featuring Dr. Amin Javer, MD, FRCSC, FARS
Video Title: Diagnosis and Treatment of Acute Sinusitus
Duration: 2 minutes, 17 seconds
Diagnosis and Treatment of Acute Sinusitus
So acute sinusitis is diagnosed mainly by history.

So the doctor will take a history and know from the history whether this is an allergy, a viral cold or an acute sinusitis and it's really all length dependent. So if it's longer than five to seven days it's likely that you're getting into a bacterial acute sinusitis.

At that stage treatment will change a little bit, so for a cold most people will take over-the-counter medications, nasal decongestants, oral decongestants.

Some people will take antihistamines; will not really work with a cold but that's because you've confused it with an allergy, and then the next step is when you get an acute bacterial sinusitis.

And then you have a variety of medications you can use, more recently we've used antibiotics as a second-line treatment for acute sinusitis. And they've switched to using nasal steroid sprays as our first-line treatment, because nasal steroid sprays actually are better anti-inflammatories than antibiotics.

So anti-inflammatories will open up the little tiny ostia and let the sinuses drain. So first-line treatment in most of these patients now is a topical intranasal corticosteroid and antibiotics are reserved as a second stage.

The issue with acute sinusitis is that if it's not treated adequately you can get the infections spread into structures near the sinuses like the eyes or the brain, and so that is something that one should be aware of.

So any swelling of the eyes or bad headaches or brain-involving symptoms should be immediately checked by either an emergency room physician or your family doctor. If an acute episode does not resolve within the first seven to ten days then patients should see their family doctor as a first step.

It can turn into a very bad infection and can involve the eyes and the brain because the sinuses sit very close to those important structures. So if you start getting swelling of your eyes, redness around the eyes or any symptoms related to your brain you should see your family doctor right away and/or go to the nearest emergency room.

Presenter: Dr. Amin Javer, Otolaryngologist, Vancouver, BC

Local Practitioners: Otolaryngologist