The diagnosis and management of sinusitis

Sinusitis, a very common health care complaint, is one of the most frequently overlooked and misunderstood diseases in clinical practice. An understanding of the pathophysiology is essential for health care providers to treat sinusitis effectively and to teach clients and families regarding management and possible complications. This article addresses clinical signs and symptoms and the differences between adults and children, as well as the subtle distinctions between acute and chronic sinusitis, and appropriate diagnostic techniques. Emphasis is placed on the diagnostic profiles of acute sinusitis relative to the different sinuses with progression to chronic sinusitis. Bacterial etiology of sinusitis is reviewed as well as management goals of sinusitis. Traditional management of sinusitis focuses on appropriate use of antibiotics, decongestants, steroids, antihistamines, and saline washes. A section on implications for practice discusses the important role of the health care provider relevant to populations at risk and possible complications, with an emphasis on primary and secondary prevention.