Inflammation of the paranasal sinuses lasting more than 12 weeks.
Diagnosis is initially clinical. Nasal endoscopy may show inflammation, purulent discharge, edema, or frank polyps.
Medical treatment includes prolonged courses of antibiotics, corticosteroids (intranasal or systemic), saline irrigation, antihistamines, and leukotriene receptor antagonists.
CT is needed if initial medical treatment fails.
Functional endoscopic sinus surgery is very effective for patients unresponsive to medical treatment.
Chronic sinusitis is inflammation of the paranasal sinuses lasting more than 12 weeks. Symptoms include facial pressure, rhinorrhea, postnasal drainage, congestion, and general malaise. Chronic sinusitis is divided into 2 groups, with and without polyps, which have slightly different treatment regimens. This monograph discusses chronic sinusitis in the absence of polyps. There is a separate monograph covering nasal polyps.
History and exam
- ciliary dysfunction
- aspirin sensitivity
- allergic rhinitis
- airway hyperreactivity/asthma
- previous sinus surgery
- severe mid-septal deviations
- concha bullosa deformity
- paradoxically bent middle turbinates
- foreign bodies
- craniofacial anomalies
- Wegener granulomatosis
- hx asthma
Chairman and Residency Program Director
Department of Otolaryngology
Saint Louis University School of Medicine
Chief, Division of Rhinology & Sinus Surgery
Co-Director, Saint Louis University Sinus Institute
JA declares that he has no competing interests.
Section Head of Rhinology, Sinus, and Skull Base Surgery
Head and Neck Institute
Cleveland Clinic Foundation
RS is Editor-in-Chief of the American Journal of Rhinology and Allergy, Oceanside Publications. RS is an author of a number of references cited in this monograph.
James H. Quillen College of Medicine
East Tennessee State University
RPB declares that he has no competing interests.
Assistant Professor of Otolaryngology - Head and Neck Surgery
St Louis University School of Medicine
TS declares that he has no competing interests.
Istanbul Training and Research Hospital
OY declares that he has no competing interests.
Academic Medical Center
CG declares that he has no competing interests.
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