The management of sinusitis has altered dramatically in the last decade, offering new hope to sufferers. There is a clearer understanding of the pathophysiology of sinus disease and new investigative technology. New surgical skills have allowed restoration of ventilation and drainage of the sinuses with functional endoscopic sinus surgery.
- Sinusitis may be underdiagnosed in both children and adults.
- Occlusion of the sinus ostia initiates the sinusitis cycle which, if untreated, leads to the development of chronic sinusitis; ostial blockage creates an ideal culture medium within the sinus; keeping the ostial passages open is essential to allow resolution of sinusitis.
- New methods – nasal endoscopy and CT scanning – can help evaluate patients with both acute and chronic sinusitis. Nasal endoscopy should be performed before CT scanning.
- First-line treatment involves antibiotics and decongestants to control infection, reduce tissue oedema, facilitate drainage and maintain ostial patency.
- Functional endoscopic sinus surgery offers new hope of permanent symptoms relief and possible cure.