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Acute rhinosinusitis

Last reviewed: 10 Jun 2025
Last updated: 10 Dec 2024

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
完整详情

其他诊断因素

  • cough
  • sore throat
  • hyposmia
  • edematous turbinate
  • fever
完整详情

危险因素

  • viral upper respiratory tract infection
  • allergic rhinitis
完整详情

诊断性检查

首要检查

  • clinical diagnosis
完整详情

Tests to avoid

  • x-ray paranasal sinuses
完整详情

需考虑的检查

  • nasal endoscopy
  • sinus culture
  • CT sinuses
  • MRI
  • lateral neck x-ray
  • allergy testing
完整详情

治疗流程

急症处理

suspected acute viral rhinosinusitis

suspected acute bacterial rhinosinusitis

suspected acute invasive fungal rhinosinusitis

持续性治疗

recurrent episodes

撰稿人

作者

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

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

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.

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.
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