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Otolaryngologia Polska = the Polish... Sep 2023Rhinosinusitis is one of the most frequently diagnosed diseases in patients seeking medical consultation. Sinusitis is a heterogeneous group of diseases and can be acute...
Rhinosinusitis is one of the most frequently diagnosed diseases in patients seeking medical consultation. Sinusitis is a heterogeneous group of diseases and can be acute or chronic. The current state of knowledge on rhinosinusitis is presented in the recommendations of the European Position Paper on Rhinosynusitis and Nasal Polyps 2020 (EPOS 2020). More and more attention is paid to the condition of the microbiota in the context of inflammatory changes in the sinuses. There is also a negative effect of excessively prescribed antibiotics on the increase in bacterial resistance to drugs and significant changes in the disturbance in the composition of the microbiota during antibiotic therapy. Since the most common etiology of acute sinusitis is viral, the use of antibiotics in uncomplicated sinusitis is unjustified. New therapeutic solutions are sought, including the use of herbal medicines. The EPOS 2020 document recommends the use of BNO 1016 in uncomplicated acute rhinosinusitis. New models of treatment also take into account the use of biological drugs, especially in the treatment of chronic rhinosinusitis.
Topics: Humans; Sinusitis; Anti-Bacterial Agents; Microbiota; Nasal Polyps
PubMed: 38032332
DOI: 10.5604/01.3001.0053.8709 -
The Journal of Allergy and Clinical... Sep 1992Even though they seldomly occur, the complications of sinusitis may be life-threatening. Complications can be local, orbital, and intracranial problems or combinations... (Review)
Review
Even though they seldomly occur, the complications of sinusitis may be life-threatening. Complications can be local, orbital, and intracranial problems or combinations thereof. Orbital complications are the most frequent, and children with acute ethmoiditis are especially prone to them. To prevent permanent loss of vision, immediate and intense therapy is most important. Intracranial complications can have few symptoms, and discordance between symptoms and severity is not uncommon, which involves the importance of early radiologic diagnosis with computed tomographic or magnetic resonance imaging scans. Orbital and intracranial complications of sinusitis are medical emergencies and must be treated by specialists. Whenever possible, the underlying sinus infection should be drained at the same time. All physicians treating acute and chronic sinusitis must keep the potentially life-threatening complications of sinusitis in mind and remain suspicious because early recognition and treatment are crucial in these cases.
Topics: Acute Disease; Brain Diseases; Chronic Disease; Humans; Orbital Diseases; Sinusitis
PubMed: 1527349
DOI: 10.1016/0091-6749(92)90184-4 -
Canadian Family Physician Medecin de... May 2011
Topics: Acute Disease; Adult; Diagnosis, Differential; Humans; Sinusitis
PubMed: 21642737
DOI: No ID Found -
The Cochrane Database of Systematic... Oct 2014The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated. (Review)
Review
BACKGROUND
The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated.
OBJECTIVES
To determine the efficacy of decongestants, antihistamines or nasal irrigation in improving symptoms of acute sinusitis in children.
SEARCH METHODS
We searched CENTRAL (2014, Issue 5), MEDLINE (1950 to June week 1, 2014) and EMBASE (1950 to June 2014).
SELECTION CRITERIA
We included randomized controlled trials (RCTs) and quasi-RCTs, which evaluated children younger than 18 years of age with acute sinusitis, defined as 10 to 30 days of rhinorrhea, congestion or daytime cough. We excluded trials of children with chronic sinusitis and allergic rhinitis.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed each study for inclusion.
MAIN RESULTS
Of the 662 studies identified through the electronic searches and handsearching, none met all the inclusion criteria.
AUTHORS' CONCLUSIONS
There is no evidence to determine whether the use of antihistamines, decongestants or nasal irrigation is efficacious in children with acute sinusitis. Further research is needed to determine whether these interventions are beneficial in the treatment of children with acute sinusitis.
Topics: Acute Disease; Adolescent; Child; Combined Modality Therapy; Histamine Antagonists; Humans; Nasal Decongestants; Nasal Lavage; Sinusitis
PubMed: 25347280
DOI: 10.1002/14651858.CD007909.pub4 -
The Medical Clinics of North America Nov 2018Some of the most common rhinologic disorders that may present to the primary care provider include disorders of hemostasis, such as epistaxis, or sinonasal inflammatory... (Review)
Review
Some of the most common rhinologic disorders that may present to the primary care provider include disorders of hemostasis, such as epistaxis, or sinonasal inflammatory disorders, such as allergic rhinitis and acute or chronic rhinosinusitis. This article is written with the intent to review these common rhinologic conditions for primary care providers and to summarize symptoms, diagnostic testing, differential diagnosis, and management/treatment approaches.
Topics: Chronic Disease; Diagnosis, Differential; Humans; Primary Health Care; Rhinitis; Rhinitis, Allergic; Sinusitis
PubMed: 30342616
DOI: 10.1016/j.mcna.2018.06.003 -
Clinical Infectious Diseases : An... Oct 2019Acute bacterial sinusitis is a frequent complication of viral upper respiratory infection (URI). We describe the clinical and virologic features of URIs that remain...
BACKGROUND
Acute bacterial sinusitis is a frequent complication of viral upper respiratory infection (URI). We describe the clinical and virologic features of URIs that remain uncomplicated and those that precede an episode of sinusitis. We hypothesize that certain viruses are more likely to lead to acute sinusitis, and we compare viruses identified at the time of diagnosis of sinusitis with those identified early in the URI.
METHODS
Children aged 48-96 months were followed longitudinally for 1 year. Nasal samples were obtained at surveillance visits, on Day 3-4 of the URI, and on Day 10, when sinusitis was diagnosed. Molecular diagnostic testing was performed on nasal washes for common respiratory viruses and pathogenic bacteria. A standardized score was used to quantify symptom severity.
RESULTS
We evaluated 519 URIs, and 37 illnesses in 31 patients met the criteria for sinusitis. Respiratory syncytial virus was detected more frequently in URI visits that led to sinusitis, compared to in uncomplicated URIs (10.8% vs 3.4%; P = .05). New viruses were detected in 29% of sinusitis episodes, and their pattern was different than those patterns observed at surveillance. The median number of URIs per subject per year was 1 (range 0-9) in uncomplicated URI subjects and 3 (range 1-9) in sinusitis subjects (P < .001).
CONCLUSIONS
Children who developed sinusitis experienced more frequent URIs, compared to children whose URIs remained uncomplicated. When nasal samples were obtained on the day of diagnosis of acute sinusitis, nearly 30% of children had a new virus identified, suggesting that some children deemed to have sinusitis were experiencing sequential viral infections.
Topics: Acute Disease; Bacteria; Bacterial Infections; Child; Child, Preschool; Female; Humans; Longitudinal Studies; Male; Nose; Respiratory Tract Infections; Sinusitis; Virus Diseases; Viruses
PubMed: 30649261
DOI: 10.1093/cid/ciz023 -
Current Allergy and Asthma Reports Jan 2016Since rhinosinusitis is an inflammatory disease, cytokines as key regulators of inflammation play a central role in its pathophysiology. In acute rhinosinusitis, several... (Review)
Review
Since rhinosinusitis is an inflammatory disease, cytokines as key regulators of inflammation play a central role in its pathophysiology. In acute rhinosinusitis, several proinflammatory cytokines of different types have been identified. Initial information about the involvement of the inflammasome in rhinosinusitis has been gained, but this area remains open for more detailed research. Although it has been accepted now that chronic rhinosinusitis (CRS) needs to be differentiated into CRS with and without nasal polyps, it has become clear that this distinction is insufficient to clearly define subgroups with uniform pathophysiology and cytokine patterns. While Th1-cytokines are mostly found in CRSsNP and Th2 cytokines in CRSwNP, there is a substantial overlap, and several other cytokines have also been detected. Attempts to identify CRS endotypes based on cytokines are ongoing but not yet generally accepted. Despite the central role of cytokines in rhinosinusitis, no specific cytokine-targeted therapies are currently available, and only very few studies have specifically addressed the effects of such biologicals in rhinosinusitis.
Topics: Acute Disease; Chronic Disease; Cytokines; Humans; Nasal Polyps; Rhinitis; Sinusitis
PubMed: 26707380
DOI: 10.1007/s11882-015-0583-4 -
Current Allergy and Asthma Reports Jun 2014Acute rhinosinusitis in children is a common disorder that is characterized by some or all of the following symptoms: fever, rhinorrhea, nasal congestion, cough,... (Review)
Review
Acute rhinosinusitis in children is a common disorder that is characterized by some or all of the following symptoms: fever, rhinorrhea, nasal congestion, cough, postnasal drainage, and facial pain/headache. It often starts as an upper respiratory tract infection that is complicated by a bacterial infection in which the symptoms worsen, persist, or are particularly severe. The accurate diagnosis of acute rhinosinusitis is challenging because of the overlap of symptoms with other common diseases, heavy reliance on subjective reporting of symptoms by the parents, and difficulties related to the physical examination of the child. Antibiotics are the mainstay of treatment. There is no strong evidence for the use of ancillary therapy. Orbital and intracranial complications may occur and are best treated early and aggressively. This article reviews the diagnosis, pathophysiology, bacteriology, treatment, and complications of acute rhinosinusitis in children.
Topics: Acute Disease; Ancillary Services, Hospital; Anti-Bacterial Agents; Child; Humans; Rhinitis; Sinusitis; Steroids
PubMed: 24700347
DOI: 10.1007/s11882-014-0443-7 -
The Cochrane Database of Systematic... Dec 2013Acute sinusitis is a common reason for primary care visits. It causes significant symptoms and often results in time off work and school. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Acute sinusitis is a common reason for primary care visits. It causes significant symptoms and often results in time off work and school.
OBJECTIVES
We examined whether intranasal corticosteroids (INCS) are effective in relieving symptoms of acute sinusitis in adults and children.
SEARCH METHODS
We searched CENTRAL 2013, Issue 4, MEDLINE (January 1966 to May week 2, 2013), EMBASE (1990 to May 2013) and bibliographies of included studies.
SELECTION CRITERIA
Randomised controlled trials (RCTs) comparing INCS treatment to placebo or no intervention in adults and children with acute sinusitis. Acute sinusitis was defined by clinical diagnosis and confirmed by radiological evidence or by nasal endoscopy. The primary outcome was the proportion of participants with either resolution or improvement of symptoms. Secondary outcomes were any adverse events that required discontinuation of treatment, drop-outs before the end of the study, rates of relapse, complications and return to school or work.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data, assessed trial quality and resolved discrepancies by consensus.
MAIN RESULTS
No new trials were found for inclusion in this update. Four studies involving 1943 participants with acute sinusitis met our inclusion criteria. The trials were well-designed and double-blind and studied INCS versus placebo or no intervention for 15 or 21 days. The rates of loss to follow-up were 7%, 11%, 41% and 10%. When we combined the results from the three trials included in the meta-analysis, participants receiving INCS were more likely to experience resolution or improvement in symptoms than those receiving placebo (73% versus 66.4%; risk ratio (RR) 1.11; 95% confidence interval (CI) 1.04 to 1.18). Higher doses of INCS had a stronger effect on improvement of symptoms or complete relief: for mometasone furoate 400 µg versus 200 µg (RR 1.10; 95% CI 1.02 to 1.18 versus RR 1.04; 95% CI 0.98 to 1.11). No significant adverse events were reported and there was no significant difference in the drop-out and recurrence rates for the two treatment groups and for groups receiving higher doses of INCS.
AUTHORS' CONCLUSIONS
Current evidence is limited for acute sinusitis confirmed by radiology or nasal endoscopy but supports the use of INCS as a monotherapy or as an adjuvant therapy to antibiotics. Clinicians should weigh the modest but clinically important benefits against possible minor adverse events when prescribing therapy.
Topics: Acute Disease; Administration, Intranasal; Adrenal Cortex Hormones; Adult; Child; Humans; Randomized Controlled Trials as Topic; Sinusitis
PubMed: 24293353
DOI: 10.1002/14651858.CD005149.pub4 -
American Family Physician May 2011Rhinosinusitis is one of the most common conditions for which patients seek medical care. Subtypes of rhinosinusitis include acute, subacute, recurrent acute, and... (Review)
Review
Rhinosinusitis is one of the most common conditions for which patients seek medical care. Subtypes of rhinosinusitis include acute, subacute, recurrent acute, and chronic. Acute rhinosinusitis is further specified as bacterial or viral. Most cases of acute rhinosinusitis are caused by viral infections associated with the common cold. Symptomatic treatment with analgesics, decongestants, and saline nasal irrigation is appropriate in patients who present with nonsevere symptoms (e.g., mild pain, temperature less than 101°F [38.3°C]). Narrow-spectrum antibiotics, such as amoxicillin or trimethoprim/sulfamethoxazole, are recommended in patients with symptoms or signs of acute rhinosinusitis that do not improve after seven days, or that worsen at any time. Limited evidence supports the use of intranasal corticosteroids in patients with acute rhinosinusitis. Radiographic imaging is not recommended in the evaluation of uncomplicated acute rhinosinusitis. Computed tomography of the sinuses should not be used for routine evaluation, although it may be used to define anatomic abnormalities and evaluate patients with suspected complications of acute bacterial rhinosinusitis. Rare complications of acute bacterial rhinosinusitis include orbital, intracranial, and bony involvement. If symptoms persist or progress after maximal medical therapy, and if computed tomography shows evidence of sinus disease, referral to an otolaryngologist is warranted.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Humans; Nasal Lavage; Rhinitis; Sinusitis
PubMed: 21534518
DOI: No ID Found