Tackling Problematic Sinusitis

A variety of respiratory viruses such as rhinovirus (the most commonest), coronavirus, and adenovirus can cause this highly infectious illness. The disease characteristics are limited to the upper respiratory tract because the virus grows well at 33’C which is the local temperature of the upper respiratory tract. The transmission is mainly through close personal contact (nasal mucus on hand) or respiratory droplets.

3. What allergies and pollutants that can lead to sinus infections?
The commonest allergen is house dust mites which can cause rhinitis and which later may lead to sinusitis. Any air pollutants can cause sinusitis thru the airway, whereas water pollutants, for example for swimmers, can lead to a similar problem.

4. Survey data confirm a remarkable overuse of antibiotics for acute sinusitis that is most likely viral rather than bacterial. Your advice?
Antibiotic is prescribed if the sinusitis is of bacterial origin and the patient has mucopurulent discharge. And the discharge starts to change colour from thick yellow to green, has a fever, headache, etc.

5. When do you recommend nasal irrigation for sinusitis?
I recommend for all cases of sinusitis to do nasal irrigation even from the beginning of acute sinusitis e.g. whenever the patient feels as having a blocked nose or when there is mucus in the nose.

6. What are the preventive measures for recurrent sinus infections?

• Avoidance of anything that the patient thinks he/she is allergic to, e.g. certain food, cats, dust.
• Use a mask or avoid dusty/ smoky area.
• Avoidance of fluffy/soft toys for children.
• Avoid using of carpets or any dust collecting material.
• To use proper pillow and bed cover to avoid exposure to house dust mite.
• To use an air filter.
• Compliance to medication, e.g. steroid nasal spray, antihistamine, and sinus rinse as prescribed by a qualified doctor.

7. Can over-the-counter medications be considered as the first line of treatment?
Yes, some medication, e.g. antihistamine, sinus rinse, and some nasal sprays.

8. Identifying the root cause for the infection should be the first line of treatment for sinus infections. Your views?
Treatment over the counter first is acceptable before we investigate further. If the problem persists or recur, then we need to further check/examine the patient by doing endoscopic examination or imaging

9. Would you recommend taking the annual flu shot as a preventive measure for senior citizens?
The flu vaccine is to prevent influenza infection and not for sinusitis.

10. What practical test is available to diagnosis chronic rhinosinusitis?
Endoscopic examination of the nose. CT scan of the paranasal sinus. An allergy test may help to determine the allergen.