Introduction. There is need for any healthcare setup to rapidly identify Sinus headache patients from other cases of Neurological and Primary headaches like Migraine and Chronic Tension type headache. Materials and Methods. 117 cases of confirmed sinusitis were evaluated and analysed for common traits which could help in rapid diagnosis of Sinusitis. Results. Unilateral, dull aching headache and facial pain, of changing intensity, lasting all day on an average of 4 to 6 hours with a previous short history of common cold in acute sinusitis is the most common pattern observed in this study. Discussion. Unilateral, dull aching headache and facial pain, of variable intensity, lasting all day on an average of 4 to 6 hours along with is highly sensitive criterion (91%) for diagnosis of acute sinusitis. This, along with a history of previous Upper Respiratory tract infection, is useful to rapidly screen patients for acute sinusitis (95% sensitive). Though a subset of other headache cases will also be included by the criteria, imaging or Endoscopy must be done in these positive cases to increase the specificity of the diagnostic criteria.
Understanding the appropriate use of diagnostics and treatment in acute rhinosinusitis is of immense importance given the high prevalence of this disease in the general population. The ability to differentiate between the principal phenotypes of acute sinusitis, namely acute viral infection (cold), acute post-viral sinusitis and acute bacterial sinusitis, determines the future management and is fundamental to providing rational therapeutic recommendations – especially as regards antibiotic treatment, which is very often overused in acute sinusitis even though bacterial phenotypes only account for 0.5–2% of all cases of the disease. The latest therapeutic recommendations contained in the EPOS2020 position paper introduce a system based on integrated care pathways (ICPs), which comprise pharmacy-supported self-care and e-health as the first level, followed by primary care as the second, with specialist care being reserved for patients who develop a more severe course of the disease, have suspected complications or suffer from recurrent acute sinusitis. Management of acute sinusitis is primarily based on symptomatic treatment modalities, with phytotherapeutic support, as well as on antiinflammatory treatment, while antibiotic therapy is used in very specific and limited indications. Complications are relatively rare in acute sinusitis and they are not considered to be associated with antibiotic intake. Considering the high prevalence of acute forms of sinusitis, their significant impact on quality of life and high direct and indirect costs of treatment, the right diagnosis and management, without unnecessary escalation of therapy, can substantially translate into a number of public health benefits.
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