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Rhinosinusitis


Presentation

  • Ethmoidal sinuses are the most complex of the sinuses and they are present at birth and attain adult size by the age of 12 years. 2.2.[intechopen.com]
  • Rhinosinusitis is one of the most common diseases present in patients with antibody deficiency.[worldallergy.org]
Fever
  • Fever may or may not be present. Attention should be paid to the periorbital and cheek areas of the face to look for cellulitis or extra sinus involvement. Culture from the nasal cavity is not useful.[worldallergy.org]
Fatigue
  • Additional signs associated with ABRS can include fever, fatigue, hyposmia, ear fullness or pressure. Physical examination: A head, ears, eyes, nose, and throat examination should be done. Pulmonary evaluation may also be needed.[worldallergy.org]
Asymptomatic
  • RARS presents similarly with three or more episodes of acute rhinosinusitis however patients are asymptomatic in between episodes of acute infection.[worldallergy.org]
Hyposmia
  • Additional signs associated with ABRS can include fever, fatigue, hyposmia, ear fullness or pressure. Physical examination: A head, ears, eyes, nose, and throat examination should be done. Pulmonary evaluation may also be needed.[worldallergy.org]
Cough
  • Symptoms: Symptoms suggestive of ARS include nasal congestion or obstruction, facial or dental pain, purulent rhinorrhea, post nasal drainage, headache and cough.[worldallergy.org]
Sleep Apnea
  • apnea Sarcoidosis Allergic rhinitis References: Fokkens WJ, Lund VJ Mullol J, et al.[worldallergy.org]
Pneumonia
  • Only about 2% of VRS become ABRS. 4 Most common bacteria responsible for ABRS are Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis. Staphylococcus aureus is also isolated in adults with ABRS.[worldallergy.org]
Sputum
  • Chronic sinusitis in severe asthma is related to sputum eosinophilia. Clin Immunol 2002;109:621-626. Lin DC, Chandra RK, Tan BK, et al. Association between severity of asthma and degree of chronic rhinosinusitis. Am J Rhinol Allergy 2011;25:205-208.[worldallergy.org]
Ear Fullness
  • Additional signs associated with ABRS can include fever, fatigue, hyposmia, ear fullness or pressure. Physical examination: A head, ears, eyes, nose, and throat examination should be done. Pulmonary evaluation may also be needed.[worldallergy.org]

Workup

  • Associated disorders that predispose patients to chronic sinusitis are discussed, as well as the diagnostic evaluation that should be performed in the workup of these patients. The role of systemic and topical therapies is also reviewed.[de.coursera.org]

Treatment

  • (17 min. quiz) Week 4 - Module 3: Chronic Rhinoinusitis: Diagnosis and Treatment (18 min. quiz) Week 5 - Module 4: The Role of Surgery for Sinusitis and Activity Evaluation (36 min. 2 quizzes) The primary objective of this course is to provide physicians[de.coursera.org]
  • Testing for allergy and immune function: Allergy testing allows identification and treatment of allergic rhinitis that often coexists with and may modify CRS.[worldallergy.org]

Etiology

  • ARS is further classified based on duration and presumed etiology as Viral rhinosinusitis (VRS) Acute bacterial rhinosinusitis (ABRS) Recurrent acute rhinosinusitis (RARS) consists of 3 or more episodes of acute bacterial rhinosinusitis (ABRS) in a year[worldallergy.org]

Prevention

  • Biofilms overlying the adenoid pad may prevent antibiotic therapy from clearing the infection. Adenoidectomy surgically removes this reservoir for chronic infection [ 17 ].[intechopen.com]

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