小结
定义
病史和体格检查
关键诊断因素
- facial pain/pressure
- nasal obstruction
- nasal discharge/postnasal drip
- purulence
- headache
其他诊断因素
- fatigue
- cough
- hyposmia/anosmia
- fever
- halitosis
- dental pain
- ear pain/pressure
危险因素
- ciliary dysfunction
- allergic rhinitis
- asthma/airway hyperreactivity
- previous sinus surgery
- dental disease
- immunodeficiency
- severe mid-septal deviations
- concha bullosa deformity
- paradoxically bent middle turbinates
- foreign bodies
- craniofacial anomalies
- smoking
- environmental pollution
- sarcoidosis
- granulomatosis with polyangiitis
诊断性检查
首要检查
- anterior rhinoscopy
- nasal endoscopy
需考虑的检查
- sinus CT
- sinus MRI
- nasal/sinus cultures
- allergy testing
治疗流程
chronic rhinosinusitis
continued symptoms despite medical therapy
撰稿人
作者
Raj Sindwani, MD, FACS, FRCS
Professor
Otolaryngology-Head and Neck Surgery
Neurological Surgery
Section of Rhinology and Endoscopic Skull Base Surgery
Head and Neck Surgery Department
Integrated Surgical Institute
Cleveland Clinic Foundation
Cleveland, OH
利益声明
RS declares that he has no competing interests.
Christopher Roxbury, MD
Associate Professor
Otolaryngology-Head and Neck Surgery
Neurological Surgery
Section of Rhinology and Endoscopic Skull Base Surgery
Head and Neck Surgery Department
Integrated Surgical Institute
Cleveland Clinic Foundation
Cleveland, OH
利益声明
CR declares that he has no competing interests.
鸣谢
Dr Raj Sindwani and Dr Christopher Roxbury would like to acknowledge Dr Jastin Antisdel, a previous contributor to this topic.
同行评议者
Ryland P. Byrd, Jr, MD
Professor
James H. Quillen College of Medicine
East Tennessee State University
Johnson City
TN
利益声明
RPB declares that he has no competing interests.
Thomas Sanford, MD
Assistant Professor of Otolaryngology - Head and Neck Surgery
St Louis University School of Medicine
St Louis
MO
利益声明
TS declares that he has no competing interests.
Ozgur Yigit, MD
Chief
ENT Department
Istanbul Training and Research Hospital
Istanbul
Turkey
利益声明
OY declares that he has no competing interests.
Christos Georgalas, MD, PhD, DLO, FRCS (ORL-HNS)
Assistant Professor/Consultant
Academic Medical Center
Amsterdam
The Netherlands
利益声明
CG declares that he has no competing interests.
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.
参考文献
关键文献
Payne SC, McKenna M, Buckley J, et al. Clinical practice guideline: adult sinusitis update. Otolaryngol Head Neck Surg. 2025 Aug;173(suppl 1):S1-56.全文 摘要
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. 摘要
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. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Acute rhinosinusitis
- Allergic rhinitis
- Allergic fungal rhinosinusitis
更多 鉴别诊断指南
- Clinical practice guideline: adult sinusitis update
- Clinical practice guideline: surgical management of chronic rhinosinusitis
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