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Wednesday, 27 November 2013

Sinusitis – Headache/Sinus headache - The Types

Sinusitis is defined as a condition of inflammation of the paranasal sinuses of which can develop headache as a result of exposure to a cold or flu virus, or an allergic reaction to pollen, mold, dust or smoke, etc..Sinusitis affects 37 million people each year.
II. Types of Sinus headache
1. Acute Sinus headache
Acute rhinosinusitis (ARS) is triggered by viral or, uncommonly, bacterial infection, causing inflammatory symptoms for ≤12 weeks(15), other suggested that if symptoms last less than 10 days, it is generally considered viral sinusitis. When symptoms last more than 10 days, it is considered bacterial sinusitis. Usually 30% to 50% of cases are bacterial. MFNS 200 μg twice daily significantly increased minimal-symptom days vs amoxicillin or placebo in patients with ARS. Results of this intranasal corticosteroids (INS) therapy indicate it can improve outcomes and potentially reduce inappropriate antibiotic use in treatment of acute sinus headache(15)


2. Chronic Sinus headache
Chronic Sinus headache is defined as a condition with symptoms lasted longer than 8 weeks. Although chronic sinusitis is not a life-threatening disease, it has a severe impact on a individual’s quality of life. Most case of chronic sinus headache are caused by structure abnormality, such as the growths of benign tumors in the sinuses or nasal polyps in the nasal cavity or sinuses, but in some case it can be caused by others, including chronic invasive sinusitis caused by dematiaceous fungi(16), allergic fungal sinusitis(17)
3. Subacute sinusitis
Subacute sinusitis is defined as a condition of symptoms of 4 to 8 weeks’ duration. In most cases, it is treated with antibiotics therapy, but according to Dr. Dohlman AW and the team in the study of Sixty-seven of the 96 subjects (70%) responded: 58 (87%) in 3 weeks and 9 (13%) in 6 weeks. Fifty-five of the responders were in the antimicrobial treatment group, and 12 were prescribed no antimicrobial medication. Twenty-nine of the 96 subjects (30%) did not respond to treatment; 22 received an antimicrobial and seven received no antimicrobial medication. The number of responders and nonresponders was similar in the antimicrobial- and nonantimicrobial-treated groups (p = NS), and no single antimicrobial medication demonstrated greater treatment effectiveness(18)
4. Recurrent acute sinusitis
Recurrent acute sinusitis is defined as a condition of reoccurring of sinusitis, three or more episodes per year, with each episode lasting less than 2 weeks. In most cases, it is caused by scar tissue formation at the surgical sit, if patient have previous surgery. Others causes can be differentiated according symptoms and the respond to medical treatment. Researchers suggested that the addition of intranasal corticosteroid, MFNS 400 microg twice daily, to antibiotics significantly reduces symptoms of acute sinusitis compared with antibiotic treatment alone(19)

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Sources
(15) http://www.ncbi.nlm.nih.gov/pubmed/22469449
(16) http://www.ncbi.nlm.nih.gov/pubmed/22239050
(17) http://www.ncbi.nlm.nih.gov/pubmed/9199091
(18) http://www.ncbi.nlm.nih.gov/pubmed/8491934
(19) http://www.ncbi.nlm.nih.gov/pubmed/11031332