Early Symptoms


To provide evidence-based recommendations for treating rhino-sinusitis in adults presenting to ENT specialists and family doctors.

Initial Assessment:

Obtain a detailed history, focusing on the duration and severity of symptoms. Perform a physical examination, including anterior rhinoscopy, to assess nasal congestion, discharge, and other abnormalities.

First Line of Management

Prescribe an immune-modulating nasal spray. This aims to enhance the body's natural defense mechanisms, reduce inflammation, and promote healing. Advise the patient on the correct nasal spray technique and the importance of adherence to the regimen.

Observation Period

Advise the patient to wait for three days after initiating the nasal spray. Educate the patient on red flag symptoms (e.g., severe headache, visual disturbances, high fever) that warrant immediate medical attention.


If the patient shows significant improvement or complete resolution of symptoms within the three-day observation period, continue the nasal spray as prescribed and provide general advice on nasal hygiene and avoiding known triggers. Further diagnostic measures should be undertaken if there's no improvement or if symptoms worsen. This may include nasal endoscopy, imaging studies, or referral to an ENT specialist for a more detailed assessment.


While our immune-modulating nasal spray is generally safe, inform the patient of potential side effects and advise them to report any adverse reactions. Emphasize the importance of differentiating between viral and bacterial causes, as the latter may require antibiotic therapy. Advise patients on lifestyle measures supporting recovery, such as staying hydrated, avoiding irritants (e.g., smoke), and using saline nasal rinses if needed.