Nasal steroids acute sinusitis

General measures that allow mucus secretions to pass more easily may be recommended when it is not possible to determine the cause. Many people, especially older persons, need more fluids to thin out secretions. Drinking more water, eliminating caffeine, and avoiding diuretics (medications that increase urination) will help. Mucous-thinning agents such as guaifenesin (Humibid®, Robitussin®) may also thin secretions. Nasal irrigations may alleviate thickened secretions. These can be performed two to four times a day either with a nasal douche device or a Water Pik® with a nasal irrigation nozzle. Warm water with baking soda or salt (½ to 1 tsp. to the pint) or Alkalol®, a nonprescription irrigating solution (full strength or diluted by half warm water), may be helpful. Finally, use of simple saline (salt) nonprescription nasal sprays (., Ocean®, Ayr®, or Nasal®) to moisten the nose is often very beneficial.

The precise mechanism through which fluticasone propionate affects rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. In 7 trials in adults, fluticasone propionate nasal spray has decreased nasal mucosal eosinophils in 66% of patients (35% for placebo) and basophils in 39% of patients (28% for placebo). The direct relationship of these findings to long-term symptom relief is not known.

Nasal irrigation with saline may be used to soften viscous secretions and improve mucociliary clearance. The mechanical cleansing of the nasal cavity with saline has been shown to benefit patients with chronic rhinosinusitis and frequent sinusitis. 20 , 21 Evidence supporting the use of nasal saline irrigation for acute upper respiratory tract infections is less conclusive. A Cochrane review found three small trials showing limited benefit for symptom relief with nasal saline irrigation in adults. 22 Nevertheless, nasal irrigation is a safe and inexpensive treatment option for patients seeking symptom relief. 1 , 23

The traditional standard study has been a four-view sinus series that includes: (1) the Waters view, in which the occiput is tipped down (patient's chin and tip of the nose are against the film surface) to facilitate viewing of the maxillary and frontal sinuses; (2) the Caldwell view, in which the forehead and tip of the nose are placed in contact with the film (this offers superior visualization of the frontal and ethmoid sinuses); (3) the lateral view, in which the sphenoid sinus and the posterior frontal sinus wall are visualized; and (4) the submentovertex view, in which the sphenoid sinuses and posterior ethmoid cells are visualized.

Nasal steroids acute sinusitis

nasal steroids acute sinusitis

The traditional standard study has been a four-view sinus series that includes: (1) the Waters view, in which the occiput is tipped down (patient's chin and tip of the nose are against the film surface) to facilitate viewing of the maxillary and frontal sinuses; (2) the Caldwell view, in which the forehead and tip of the nose are placed in contact with the film (this offers superior visualization of the frontal and ethmoid sinuses); (3) the lateral view, in which the sphenoid sinus and the posterior frontal sinus wall are visualized; and (4) the submentovertex view, in which the sphenoid sinuses and posterior ethmoid cells are visualized.

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