Sinusitis is the inflammation of the paranasal sinuses. It can be the result of many infectious agents, e.g. viral, bacteria, allergic or fungal. Colds, flu and allergies predispose one to sinusitis. Usually sinusitis from viruses resolves in seven to ten days. Anything longer usually has become bacterial (less then 1% of viral infections progress to bacteria). Symptoms include nasal congestion, cough, and facial pressure, green to purulent discharge, teeth pain, and headache. Other predisposing factors include septal deviation, nasal polyps, tumors, allergies and foreign bodies in the nose.

When it comes to treatment, it is very important to understand that the key to successful treatment is dependent not only antibiotics, but to reestablish the natural drainage process of the sinuses. That means using nasal saline, nasal steroids and other decongestants. Antihistamines should only be included in the treatment when there is an underlying allergic component. Treatment should last a minimum of two weeks and possibly longer dependent upon symptoms. Even after resolution of the acute symptoms, other symptoms such as cough may linger on. When aggressive medical treatment has failed, then one should see an ears, nose and throat specialist for possible surgical treatment.

Jeff Sandler, MD

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