Acute rhinosinusitis

Patients should be instructed to notify their physician if symptoms do not improve as expected. Pain and fever should begin to improve within 2-3 days without treatment in patients with acute viral rhinosinusitis.[1]Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-39. https://journals.sagepub.com/doi/full/10.1177/0194599815572097 http://www.ncbi.nlm.nih.gov/pubmed/25832968?tool=bestpractice.com Nasal obstruction and drainage may take a week or more to improve. Patients should be advised to avoid cigarette smoke, environmental pollutants and allergens, alcohol, air travel, and diving in deep water. Warm facial packs and nasal saline irrigation may be useful. Adequate sleep and hydration should be encouraged. If air travel is unavoidable, advise patients to avoid stress, ensure a good night's sleep before traveling, stay well hydrated, avoid alcohol and caffeine, and consider using intranasal decongestant spray just before boarding the flight.