The American Academy of Otolaryngology – Head & Neck Surgery recently published an updated clinical practice guideline on adult sinus infections. Sinus infections, often peaking during allergy and cold seasons, account for about $11 Billion in annual direct expenditures in this country and affect about 30 million people annually. And as sinus sufferers know, the indirect costs of lost productivity and missed work can be worse than the dollars spent.
The updated guidelines incorporate additional research and expert panel opinion on the best practices for diagnosis and treatment of sinus infections. Sinusitis is diagnosed in a variety of settings, such as urgent care clinics, primary care offices, the emergency department or even the intensive care unit. The keys recommendations that are reiterated are the general conservative approach to antibiotic use (most cases lasting less than a couple weeks do not need antibiotics), the importance of longer-duration antibiotics for true longer-acting bacterial infections, and the importance of sinus culture, nasal endoscopy (rhinoscopy), and three-dimensional imaging when antibiotics are not working. Allergic rhinitis and chronic headaches or migraines are important disorders that can masquerade as sinus infections, so getting these sorted out early is helpful for the best most cost-effective recovery.
Most otolaryngologists (ear nose and throat experts) recommend nasal saline, nasal steroid sprays, and mucolytics like Mucinex to help clear infections. Office based procedures like nasal endoscopy, CT imaging, and Balloon Sinuplasty can be performed to help with speedy diagnosis and treatment. If there are other signs of allergies, allergy evaluation is usually recommended.
AAO-HNS Patient Information Guidelines on Sinus Infections