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Chapter 8: rhinosinusitis.
MedLine Citation:
PMID:  22794681     Owner:  NLM     Status:  In-Data-Review    
Rhinosinusitis is defined as inflammation of one or more of the paranasal sinuses and affects ∼16% of the population. Acute rhinosinusitis is defined as symptoms lasting <4 weeks and subacute rhinosinusitis is between 4 and 8 weeks. Chronic rhinosinusitis (CRS) is defined as symptoms lasting >8-12 weeks. CRS is divided into three groups: CRS with nasal polyps, CRS without nasal polyps, and allergic fungal rhinosinusitis. The sinus cavities are lined with pseudostratified ciliated columnar epithelial cells interspersed with mucous goblet cells. Cilia continuously sweep the mucous toward the ostial openings and are important in maintaining the proper environment of the sinus cavities. The frontal, maxillary, and anterior ethmoid sinuses drain into the ostiomeatal unit of the middle meatus. The posterior ethmoid sinuses and superior sphenoid sinuses drain into the sphenoethmoid recess of the superior meatus. Most acute sinus infections are caused by viruses and, therefore, it is not surprising that the majority of patients improve within in 2 weeks without antibiotic treatment. A bacterial infection should be considered if symptoms worsen or fail to improve within 7-10 days. Amoxicillin, trimethoprim-sulfamethoxazole, or doxycycline are first-line therapy. The Joint Task Force on Practice Parameters for Allergy and Immunology suggests assessing response to symptoms after 3-5 days of therapy and continuing for an additional 7 days if there is improvement. Combining an intranasal corticosteroid with an antibiotic reduces symptoms more effectively than antibiotics alone.
Mary S Georgy; Anju T Peters
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Allergy and asthma proceedings : the official journal of regional and state allergy societies     Volume:  33 Suppl 1     ISSN:  1539-6304     ISO Abbreviation:  Allergy Asthma Proc     Publication Date:    2012 May-Jun
Date Detail:
Created Date:  2012-07-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9603640     Medline TA:  Allergy Asthma Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-7     Citation Subset:  IM    
Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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