不伴鼻息肉的慢性鼻窦炎
小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 面部疼痛/发胀
- 鼻塞
- 流涕/鼻后滴漏
- 脓液
- 头痛
其他诊断因素
- 疲劳
- 咳嗽
- 嗅觉减退/失嗅
- 发热
- 口臭
- 牙疼
- 耳痛/闷胀
危险因素
- 纤毛功能异常
- 阿司匹林耐受不良
- 变应性鼻炎
- 气道高反应性/哮喘
- 以前的鼻窦手术
- 免疫缺陷
- 严重的鼻中隔偏曲
- 泡性鼻甲畸形
- 中鼻甲反向偏曲
- 异物
- 颅面畸形
- 吸烟
- 结节病
- 肉芽肿性多血管炎
- 哮喘病史
诊断性检查
首要检查
- 前鼻镜检查
- 鼻内镜检查
需考虑的检查
- 鼻窦 CT
- 鼻窦 MRI
- 鼻/鼻窦分泌物培养
- 致敏原检测
治疗流程
慢性鼻窦炎
经药物治疗，症状仍持续存在者
撰稿人
作者
Raj Sindwani, MD, FACS, FRCS
Section Head of Rhinology, Sinus, and Skull Base Surgery
Head and Neck Institute
Cleveland Clinic Foundation
Cleveland
OH
利益声明
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
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.
鉴别诊断
- 急性鼻窦炎
- 变应性鼻炎
- 过敏性真菌鼻窦炎
更多 鉴别诊断指南
- 2020 年鼻炎：一份实践参数更新
- 2020 年欧洲鼻窦炎和鼻息肉立场声明
更多 指南患者教育信息
鼻窦炎（急性）
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明