Summary
Definition
History and exam
Key diagnostic factors
- facial pain/pressure
- nasal obstruction
- nasal discharge/postnasal drip
- purulence
- headache
Other diagnostic factors
- fatigue
- cough
- hyposmia/anosmia
- fever
- halitosis
- dental pain
- ear pain/pressure
Risk factors
- ciliary dysfunction
- aspirin sensitivity
- allergic rhinitis
- airway hyperreactivity/asthma
- previous sinus surgery
- immunodeficiency
- severe mid-septal deviations
- concha bullosa deformity
- paradoxically bent middle turbinates
- foreign bodies
- craniofacial anomalies
- smoking
- sarcoidosis
- granulomatosis with polyangiitis
- history of asthma
Diagnostic investigations
1st investigations to order
- anterior rhinoscopy
- nasal endoscopy
Investigations to consider
- sinus CT
- sinus MRI
- nasal/sinus cultures
- allergy testing
Treatment algorithm
chronic sinusitis
patients with continued symptoms despite medical therapy
Contributors
Authors
Raj Sindwani, MD, FACS, FRCS
Section Head of Rhinology, Sinus, and Skull Base Surgery
Head and Neck Institute
Cleveland Clinic Foundation
Cleveland
OH
Disclosures
RS is an author of a number of references cited in this topic.
Christopher Roxbury, MD
Assistant Professor
Rhinology and Endoscopic Skull Base Surgery
Section of Otolaryngology - Head and Neck Surgery
Department of Surgery
University of Chicago Medicine & Biological Sciences
Chicago
IL
Disclosures
CR declares that he has no competing interests.
Acknowledgements
Dr R Sindwani and Dr C Roxbury would like to acknowledge Dr J Antisdel, a previous contributor to this topic.
Peer reviewers
Ryland P. Byrd, Jr, MD
Professor
James H. Quillen College of Medicine
East Tennessee State University
Johnson City
TN
Disclosures
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
Disclosures
TS declares that he has no competing interests.
Ozgur Yigit, MD
Chief
ENT Department
Istanbul Training and Research Hospital
Istanbul
Turkey
Disclosures
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
Disclosures
CG declares that he has no competing interests.
Differentials
- Acute sinusitis
- Allergic rhinitis
- Allergic fungal sinusitis
More DifferentialsGuidelines
- Rhinitis 2020: A practice parameter update
- European Position Paper on rhinosinusitis and nasal polyps 2020
More GuidelinesPatient leaflets
Sinusitis
More Patient leaflets
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