Summary
定义
病史和体格检查
关键诊断因素
- 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
其他诊断因素
- cough
- sore throat
- hyposmia
- edematous turbinate
- fever
危险因素
- viral upper respiratory tract infection
- allergic rhinitis
诊断性检查
首要检查
- clinical diagnosis
Tests to avoid
- x-ray paranasal sinuses
需考虑的检查
- nasal endoscopy
- sinus culture
- CT sinuses
- MRI
- lateral neck x-ray
- allergy testing
治疗流程
suspected acute viral rhinosinusitis
suspected acute bacterial rhinosinusitis
suspected acute invasive fungal rhinosinusitis
recurrent episodes
撰稿人
作者
Gordon H. Sun, MD, MBA, MSc

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
利益声明
GHS is a contractor for MAXIMUS, Inc.
鸣谢
Dr Gordon H. Sun would like to gratefully acknowledge Dr Melissa A. Pynnonen and Dr Joseph K. Han, previous contributors to this topic.
利益声明
MAP and JKH declare that they have no competing interests.
同行评议者
Michael S. Benninger, MD
Professor of Otolaryngology Head and Neck Surgery
Cleveland Clinic
Lerner College of Medicine
Cleveland
OH
利益声明
MSB declares that he has no competing interests.
Daniel Merenstein, MD
Director of Research Family Medicine
Georgetown University
Washington, DC
利益声明
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
利益声明
ARJ is a consultant for iView Therapeutics, GSK, and Sanofi.
参考文献
关键文献
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.全文 摘要
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. 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.全文
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.全文 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
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