Chronic Sinusitis Questions & Answers

Updated: Jul 01, 2019
  • Author: Itzhak Brook, MD, MSc; Chief Editor: John L Brusch, MD, FACP  more...
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Questions & Answers

Overview

What is chronic sinusitis?

What are the signs and symptoms of chronic sinusitis?

What are risk factors for chronic sinusitis?

What is the goal of medical therapy for chronic sinusitis?

What are the diagnostic criteria for chronic rhinosinusitis (CRS)?

What anatomy knowledge is needed to understand the pathophysiology and management of chronic sinusitis?

What triggers stasis of secretions inside the sinuses in chronic sinusitis?

What is the pathophysiology of chronic sinusitis?

What is the role of bacteria in the pathogenesis of chronic sinusitis?

Which factors contribute to inflammation in chronic rhinosinusitis (CRS)?

What is the etiology of chronic sinusitis?

What is the role of bacterial infection in chronic sinusitis?

What types of bacteria are involved in the etiology of chronic sinusitis?

What is the role of fungal agents in the etiology of chronic sinusitis?

What are the risk factors for chronic sinusitis?

What is the prevalence of chronic sinusitis in the US?

What is the global prevalence of chronic sinusitis?

Why is rhinosinusitis more prevalent in children?

What is the prognosis of chronic sinusitis?

Presentation

What is the role of medical history in the evaluation of chronic rhinosinusitis (CRS)?

Which clinical history is characteristic of chronic sinusitis?

What are the signs and symptoms of chronic sinusitis?

Which clinical history is characteristic of chronic sinusitis in pediatric patients?

What factors should the patient history of chronic sinusitis focus on?

Which physical findings are characteristic of chronic sinusitis?

How is tenderness or swelling assessed in chronic sinusitis?

What is the role of an oropharynx exam in the evaluation of chronic sinusitis?

What is the role of anterior rhinoscopy in the evaluation of chronic sinusitis?

Which exams may be helpful supplements to the nasal exam for chronic sinusitis?

What is the role of an ear exam for evaluation of chronic sinusitis?

What are ophthalmic manifestations of chronic sinusitis?

What is the role of laryngeal exam in the evaluation of chronic sinusitis?

What is the role of cranial nerve exam in the evaluation of chronic sinusitis?

Which physical findings are characteristic of chronic fungal sinusitis?

What are the diagnostic criteria for chronic rhinosinusitis (CRS)?

How and when were amendments made to the diagnostic criteria for chronic rhinosinusitis (CRS)?

What is the role of imaging in the diagnosis of chronic sinusitis?

How is chronic rhinosinusitis (CRS) defined?

What are the potential serious complications of chronic sinusitis?

DDX

Which conditions should be considered in the differential diagnosis of chronic sinusitis?

What are the differential diagnoses for Chronic Sinusitis?

Workup

What is included in the workup for chronic sinusitis?

How is chronic rhinosinusitis (CRS) staged?

How are cultures obtained for the workup of chronic sinusitis?

What is the role of maxillary sinus tap in the workup of chronic sinusitis?

What is the role of endoscopy in the workup of chronic sinusitis?

What is the role of radiography in the workup of chronic sinusitis?

What is the preferred imaging technique for evaluating chronic rhinosinusitis (CRS)?

What is the role of contrast-enhanced CT in the evaluation of chronic sinusitis?

When is coronal CT scanning indicated in the workup of chronic sinusitis?

What is the role of MRI in the evaluation of chronic sinusitis?

Which biopsy findings are characteristic of chronic sinusitis?

What is the indication for a brush or turbinate biopsy in the workup of chronic sinusitis?

What is the indication for an endoscopic biopsy in the workup of chronic sinusitis?

Which supplemental tests may be indicated in the workup of chronic sinusitis?

Treatment

What are the goals of medical therapy for chronic rhinosinusitis (CRS)?

When is inpatient treatment indicated for chronic sinusitis?

What are the AAO-HNSF treatment guidelines for adult chronic sinusitis?

How are the predisposing factors managed in chronic sinusitis?

What is the role of zinc in the prevention of chronic sinusitis?

How are environmental and allergic risk factors managed to prevent chronic sinusitis?

What is the role of gastroesophageal reflux disease (GERD) in chronic sinusitis?

What is necessary to cure chronic sinusitis?

What is the role of leukotriene inhibitors in chronic sinusitis?

What is the symptomatic treatment of chronic sinusitis?

What is the role of antibiotics in the treatment of chronic rhinosinusitis (CRS)?

What is the initial choice for antimicrobials in the treatment of chronic sinusitis?

What are the therapeutic antimicrobial regimens used to treat chronic sinusitis?

What is the efficacy of systemic antibiotic therapy for chronic sinusitis?

What are the treatment options for chronic rhinosinusitis (CRS)?

What is the optimal duration of antibiotic therapy for chronic rhinosinusitis (CRS)?

What is the role of nebulized antibiotics and antifungal agents in the treatment of chronic sinusitis?

Which factors increase the likelihood of difficult-to-treat chronic sinusitis?

What is the prime therapy for chronic sinusitis?

When is surgery indicated in the treatment of chronic sinusitis?

What is the goal of surgery for chronic sinusitis?

What is the surgical procedure of choice for the treatment of chronic sinusitis?

What are the surgical options for chronic maxillary sinusitis?

What is the treatment of choice for chronic fungal sinusitis?

Which dietary measures may be helpful in the treatment of chronic sinusitis?

What is the most common complication of chronic sinusitis?

When should patients with chronic sinusitis be referred to an otolaryngologist?

What are orbital complications in chronic sinusitis?

What can result from untreated chronic sinusitis?

Which health risk is increased with medically-resistant chronic rhinosinusitis (CRS)?

When should patients with chronic sinusitis be referred to an otolaryngologist?

When should patients with chronic sinusitis be referred to an ophthalmologist?

What long-term monitoring is needed for chronic sinusitis?

Medications

What are the goals of drug treatment for chronic sinusitis?

What are the criteria for antibiotic selection for the treatment of chronic sinusitis?

How are antibiotics administered for the treatment of chronic sinusitis?

What are the first-line antibiotics for treatment of chronic sinusitis?

Which medications in the drug class Leukotriene Receptor Antagonist are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Expectorants are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Mast cell stabilizers are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Nasal sprays are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Corticosteroids are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Decongestants are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Anti-Infectives are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Tetracyclines are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Fluoroquinolones are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Macrolides are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Cephalosporins are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Penicillins are used in the treatment of Chronic Sinusitis?

Which medications in the drug class Interleukin Inhibitors are used in the treatment of Chronic Sinusitis?