Sinusitis

In BMJ 2007:334:358-361 ENT specialists from the Aberdeen Royal Infirmary summarise the knowledge base on sinusitis - which they refer to as rhinosinusitis. As a simple GP, what I would like to know is how should I diagnose and treat the problem. As usual, things are not as simple as they seem. Has the patient got acute (rhino)sinusitis; <12 weeks duration and 2 or more of blockage/congestion, discharge, facial pain and loss of smell. If so then analgaesia helps, topical steroid nasal spray can help and antibiotics have a small but significant improvement in cure rate.
Chronis sinusitis is >12w duration with one of : facial pain or pressure, discoloured discharge and reduction or loss of smell. Topical steroids are the first line of treatment here and oral steroids may also be considered.
These days surgery for these problems is usually done endoscopically. In acute cases it is used to release pus and in chronic cases to restore sinus ventilation and drainage.