SINUSITIS

acute or chronic infection of the paranasal sinuses (i.e., the cavities in the bones that adjoin the nose). Acute sinusitis usually results from infections of the upper respiratory tract such as the common cold. Acute sinusitis may occur at any time after six months of age. By the age of four years the maxillary sinus is the one most commonly affected. General diseases, such as measles, also frequently precipitate acute sinusitis, as may the penetration of infected water from swimming. The symptoms of acute sinusitis are pain and headache, tenderness over the affected area, nasal obstruction and discharge, and malaise. Treatment of the disorder is directed primarily at overcoming the infecting organism by the use of systemic antibiotics such as penicillin and at encouraging drainage of the sinuses by the use of vasoconstricting nose drops and inhalations. If the infection persists, the pus localized in any individual sinus may need to be removed by means of a minor surgical procedure known as lavage, in which the maxillary or sphenoidal sinuses are irrigated with water or a saline solution. Chronic sinusitis may follow repeated or neglected attacks of acute sinusitis, particularly if there is impaired nasal breathing or drainage from intranasal obstruction. The symptoms of chronic sinusitis are a tendency to colds, purulent nasal discharge, obstructed breathing, loss of smell, and sometimes headache. Pain is not a feature of chronic sinusitis. If antibiotic therapy or repeated lavage do not alleviate the condition, surgery may be necessary.