Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- pressão/dor facial
- obstrução nasal
- secreção nasal/gotejamento pós-nasal
- purulência
- cefaleia
Other diagnostic factors
- fadiga
- tosse
- hiposmia/anosmia
- febre
- halitose
- dor de dente
- dor de ouvido/pressão
Risk factors
- disfunção ciliar
- sensibilidade à aspirina
- rinite alérgica
- hiper-reatividade das vias aéreas/asma
- cirurgia prévia dos seios paranasais
- imunodeficiência
- desvios graves do septo
- deformidade da concha bolhosa
- cornetos médios curvados paradoxalmente
- corpos estranhos
- anormalidades craniofaciais
- tabagismo
- poluição ambiental
- sarcoidose
- granulomatose com poliangiite
- história de asma
Diagnostic tests
1st tests to order
- rinoscopia anterior
- endoscopia nasal
Tests to consider
- tomografia computadorizada (TC) dos seios da face
- ressonância nuclear magnética (RNM) dos seios nasais
- culturas do seio nasal/sinusais
- teste de alergia
Treatment algorithm
rinossinusite crônica
continuação de sintomas apesar da terapia medicamentosa
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. RS is a consultant for Optinose, Stryker, and 3D Matrix.
Christopher Roxbury, MD
Associate 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.
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.
References
Key articles
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(suppl 2):S1-S39.Full text Abstract
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. Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Rinossinusite aguda
- Rinite alérgica
- Rinossinusite fúngica alérgica
More DifferentialsGuidelines
- International consensus statement on allergy and rhinology: rhinosinusitis
- European Position Paper on rhinosinusitis and nasal polyps 2020
More GuidelinesPatient information
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