0521779407-19 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:21
1354 Sinusitis➣Adjunctive treatments
Topical steroids, decongestants, mucolytics as indicated
Warm compresses
Humidification
Nasal saline
Antipyretics
➣Surgery
Maxillary sinus puncture for culture/treatment in selected
cases
Recurrent acute sinusitis may be treated successfully with
endoscopic or open techniques to reduce frequency, duration,
intensity of infections
■Side Effects
➣Medical
Allergy/reaction to antibiotic
Psuedomembranous colitis
Usual side effects of decongestants/steroids (see Rhinitis chap-
ter)
➣Surgery
Rare complication from maxillary sinus puncture
Rare orbital/intracranial or other complications of sinus
surgery
Recurrence or persistence of infection
Unusual surgical complications (eg, bleeding, anesthesia
related)
Rarely may require hospitalization for persistent infection,
complications
■Chronic Sinusitis
■Antibiotics for 3 weeks (same bacteria as acute sinusitis+anaerobes,
higher incidence of Staph, Pseudomonas)
■Immunocompromised patients may have other infectious agents
including fungus
■Treat with second line antibiotics as listed above
■Consider oral prednisone
■Topical nasal steroids
➣Adjunctive Treatments
➣Decongestants, mucolytics as indicated
➣Humidification
➣Nasal saline
➣Surgery