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Acute rhinosinusitis

Последний просмотренный: 20 Aug 2025
Last updated: 10 Dec 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • symptoms <10 days (acute viral rhinosinusitis)
  • symptoms >10 days but <4 weeks (acute bacterial rhinosinusitis)
  • symptoms that worsen after an initial improvement (acute bacterial rhinosinusitis)
  • purulent nasal discharge
  • nasal obstruction
  • facial pain/pressure
  • severe symptoms at onset (acute bacterial rhinosinusitis)
  • dental pain
Полная информация

Другие диагностические факторы

  • cough
  • sore throat
  • hyposmia
  • edematous turbinate
  • fever
Полная информация

Факторы риска

  • viral upper respiratory tract infection
  • allergic rhinitis
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • clinical diagnosis
Полная информация

Tests to avoid

  • x-ray paranasal sinuses
Полная информация

Исследования, проведение которых нужно рассмотреть

  • nasal endoscopy
  • sinus culture
  • CT sinuses
  • MRI
  • lateral neck x-ray
  • allergy testing
Полная информация

Алгоритм лечения

Острый

suspected acute viral rhinosinusitis

suspected acute bacterial rhinosinusitis

suspected acute invasive fungal rhinosinusitis

ПРОДОЛЖЕНИЕ

recurrent episodes

Составители

Авторы

Gordon H. Sun, MD, MBA, MSc
Gordon H. Sun

Director of Specialty Care

High Desert Regional Health Center

Lancaster

CA

Clinical Associate Professor of Otolaryngology-Head and Neck Surgery

Charles R. Drew University of Medicine and Science

Los Angeles

CA

Раскрытие информации

GHS is a contractor for MAXIMUS, Inc.

Выражение благодарностей

Dr Gordon H. Sun would like to gratefully acknowledge Dr Melissa A. Pynnonen and Dr Joseph K. Han, previous contributors to this topic.

Раскрытие информации

MAP and JKH declare that they have no competing interests.

Рецензенты

Michael S. Benninger, MD

Professor of Otolaryngology Head and Neck Surgery

Cleveland Clinic

Lerner College of Medicine

Cleveland

OH

Раскрытие информации

MSB declares that he has no competing interests.

Daniel Merenstein, MD

Director of Research Family Medicine

Georgetown University

Washington, DC

Раскрытие информации

DM declares that he has no competing interests.

Amin R. Javer, MD, FRCSC, FARS

Clinical Professor

Division of Otolaryngology

University of British Columbia

Vancouver

Canada

Раскрытие информации

ARJ is a consultant for iView Therapeutics, GSK, and Sanofi.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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.Полный текст  Аннотация

Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021 Mar;11(3):213-739. Аннотация

Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.Полный текст

Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020 Feb 20;58(suppl s29):1-464.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Differentials

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  • Guidelines

    • Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases
    • Diagnosis and management of sinusitis in adults and children: 2023 update
    More Guidelines
  • Patient information

    Sinusitis

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