Role of Topical Application of Adrenaline and Lignocaine in The Middle Meatus for Symptomatic Relief in Acute Maxillary Sinusitis

INTRODUCTION Acute sinusitis is a common inflammatory condition of the paranasal sinuses characterized by facial pain, nasal obstruction, and mucopurulent discharge. Topical nasal decongestants and local anesthetics are routinely used to achieve symptomatic relief. This study evaluates the therapeutic efficacy and safety of topical adrenaline and lignocaine applied to the middle meatus in patients with bilateral acute maxillary sinusitis. MATERIALS AND METHODS A prospective, randomized controlled trial was conducted on 100 adult patients diagnosed with bilateral acute maxillary sinusitis. Patients were randomly allocated into two groups. Group A (n=50) received a cotton pledget soaked in 2 ml of 4% lignocaine with 1:10,000 adrenaline, while Group B (n=50) received normal saline pledgets. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, nasal obstruction, and discharge, along with endoscopic evaluation of mucosal edema and pus clearance. Assessments were performed at baseline, 1 hour, and 24 hours post-intervention. Hemodynamic parameters and adverse events were monitored. OBSERVATIONS & RESULTS Baseline demographic and clinical characteristics were comparable between groups. Group A demonstrated significantly greater improvement in pain scores at 1 hour and 24 hours (p<0.001). Endoscopic findings showed superior resolution of mucosal edema, pus clearance, and middle meatal patency in Group A. Mild and transient adverse effects were noted in a few patients, with no serious complications. CONCLUSION Topical application of 4% lignocaine with 1:10,000 adrenaline in the middle meatus provides rapid, safe, and effective symptomatic relief in acute maxillary sinusitis and may reduce dependence on prolonged medical therapy.