Conditions of the Sinus and Nose

Description

Allergic rhinitis (hay fever) is an allergic reaction causing sneezing, congestion, itchy nose, and watery eyes. It is caused by allergens like pollen, pet dander, mold, and insects.

Treatment

Supportive

• Environmental control measures and allergen

Pharmacological

Nasal Decongestant:

• Xylometazoline Hydrochloride: Indicated for nasal congestion.

• Child 6–11 years: 1–2 drops 1–2 times a day for a maximum of 5 days.
• Child 12–17 years: 2–3 drops 2–3 times a day for a maximum of 7 days.
• Adults: 2–3 drops 2–3 times a day for a maximum of 7 days.

Antihistamines: For mild allergic rhinitis.

• Loratadine: 10 mg once
• Cetirizine: 10 mg once

Nasal Corticosteroids:

• Mometasone Furoate: For prophylaxis and treatment of seasonal allergic or perennial rhinitis.
• Children 3–11 years: 50 mcg daily, sprayed into each nostril.
• Children 12–17 years: 100 mcg daily, increased to 200 mcg if necessary.
• Adults: 100 mcg daily, increased to 200 mcg if necessary. 
  • Fluticasone: For prophylaxis and treatment of seasonal allergic or perennial rhinitis.

• Children 4–11 years: 50 mcg once daily, increased to 50 mcg twice daily if necessary.
• Children 12–17 years: 100 mcg once daily, increased to 100 mcg twice daily if necessary.
• Adults: 100 mcg once daily, increased to 100 mcg twice daily if necessary.

Description

Rhinosinusitis is the inflammation of the nasal passages and sinuses extending beyond 7-10 days . It can be acute (lasting less than 4 weeks), subacute (4-12 weeks), chronic (over 12 weeks), or recurrent (four or more episodes per year).

Signs and Symptoms

• Runny nose
• Postnasal drip
• Nasal congestion
• Sinus pain or pressure
• Headache
• Toothache
• Loss of smell
• Halitosis (bad breath)
• Cough (more common in children)

Treatment

Supportive

• Nasal saline irrigation to reduce congestion and flush out

Pharmacological

Pain Management: Acute Rhinosinusitis

• Paracetamol (Acetaminophen):

• Adults: 500 mg to 1 g every 4-6 hours as needed (maximum 4 g per day).
• Children 6-12 years: 250-500 mg every 4-6 hours as needed (maximum 2 g per day).
• Children 1-5 years: 120-250 mg every 4-6 hours as needed (maximum 1 g per day).

• Ibuprofen:

• Adults: 200-400 mg every 4-6 hours as needed (maximum 1.2 g per day).
• Children 4-7 years: 150 mg every 8 hours (maximum 5-10 mg/kg daily).
• Children 7-12 years: 200 mg every 8 hours (maximum 5-10 mg/kg daily).

Nasal Decongestants:

• Pseudoephedrine:
  • Adults: 60 mg every 4-6 hours (maximum 240 mg per day).
  • Children over 6 years: 30 mg every 4-6hours (maximum 120 mg per day).
• Xylometazoline hydrochloride
  • Child 6–11 years: 1–2 drops 1–2 times a day as required for maximum duration of 5 days, 05% solution to be administered into each nostril
  • Child 12–17 years: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 1% solution to be administered into each nostril
  • Adult: 2–3 drops 2–3 times a day as required for maximum duration of 7 days, 1% solution to be administered into each nostril

Nasal Corticosteroids:

• Fluticasone:
  • Adults: 100 mcg once daily into each nostril, can be increased to 100 mcg twice daily if necessary
  • Children: 50 mcg once daily into each nostril, can be increased to 50 mcg twice daily if necessary
• Mometasone:
  • Adults: 100 mcg once daily into each nostril, can be increased to 200 mcg daily if necessary
  • Children: 50 mcg once daily into each nostril, can be increased to 100 mcg daily if necessary

Antibiotics: Acute Rhinosinusitis (If bacterial infection is suspected)

• Amoxicillin:
  • Adults: 500 mg every 8 hours or 1 g every 12 hours for 7-10 days.
  • Children: 50 mg/kg/day in divided doses every 8 hours (not to exceed 1 g per dose) for 7-10 days.
• Doxycycline:
  • Adults: 100 mg every 12 hours for 7-10 days

Description

Nasal polyposis involves the growth of polyps in the nasal passages or sinuses, often associated with chronic rhinosinusitis.

Signs and Symptoms

• Nasal obstruction
• Reduced sense of smell
• Postnasal drip
• Nasal congestion
• Sinus pressure

Treatment

Nasal Corticosteroids:

• Fluticasone

• Adults: 100 mcg once daily into each nostril, can be increased to 100 mcg twice daily if necessary.
• Children: 50 mcg once daily into each nostril, can be increased to 50 mcg twice daily if necessary.

• Mometasone:

Adults: 100 mcg once daily into each nostril, can be increased to 200 mcg daily if necessary.

Children: 50 mcg once daily into each nostril, can be increased to 100 mcg daily if necessary.