Resumen
Definición
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
- environmental pollution
- sarcoidosis
- granulomatosis with polyangiitis
- history of asthma
Diagnostic investigations
1st investigations to order
- anterior rhinoscopy
- nasal endoscopy
Investigations to consider
- maxillofacial CT
- sinus MRI
- nasal/sinus cultures
- allergy testing
Treatment algorithm
chronic rhinosinusitis
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. 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
利益声明
CR declares that he has no competing interests.
鸣谢
Dr R Sindwani and Dr C Roxbury would like to acknowledge Dr J Antisdel, a previous contributor to this topic.
同行评议者
Ryland P. Byrd, Jr, MD
Professor
James H. Quillen College of Medicine
East Tennessee State University
Johnson City
TN
利益声明
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
利益声明
TS declares that he has no competing interests.
Ozgur Yigit, MD
Chief
ENT Department
Istanbul Training and Research Hospital
Istanbul
Turkey
利益声明
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
利益声明
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.
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-S39.全文 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. 摘要
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. 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
- Acute rhinosinusitis
- Allergic rhinitis
- Allergic fungal rhinosinusitis
更多 鉴别诊断指南
- International consensus statement on allergy and rhinology: rhinosinusitis
- European Position Paper on rhinosinusitis and nasal polyps 2020
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