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Australian Family Physician Jun 2016Acute and chronic sinusitis are common primary care presentations. They are caused by mucosal inflammation, which inhibits mucociliary function of the nose and paranasal... (Review)
Review
BACKGROUND
Acute and chronic sinusitis are common primary care presentations. They are caused by mucosal inflammation, which inhibits mucociliary function of the nose and paranasal sinuses.
OBJECTIVE
This article provides an overview of acute and chronic sinusitis, and a guide to workup and management in a primary care setting. Complications and other indications for referral are discussed.
DISCUSSION
Sinusitis involves a wide spectrum of presentations, both acute and chronic. It is primarily a medical condition, and surgical management is reserved for complicated or refractory cases.
Topics: Acute Disease; Adult; Child; Chronic Disease; Humans; Primary Health Care; Sinusitis
PubMed: 27622225
DOI: No ID Found -
Immunology and Allergy Clinics of North... May 2020Chronic rhinosinusitis (CRS) is persistent inflammation and/or infection of the nasal cavity and paranasal sinuses. Recent advancements in culture-independent molecular... (Review)
Review
Chronic rhinosinusitis (CRS) is persistent inflammation and/or infection of the nasal cavity and paranasal sinuses. Recent advancements in culture-independent molecular techniques have enhanced understanding of interactions between sinus microbiota and upper airway microenvironment. The dysbiosis hypothesis-alteration of microbiota associated with perturbation of the local ecological landscape-is suggested as a mechanism involved in CRS pathogenesis. This review discusses the complex role of the microbiota in health and in CRS and considerations in sinus microbiome investigation, dysbiosis of sinus microbiota in CRS, microbial interactions in CRS, and development of preclinical models. The authors conclude with future directions for CRS-associated microbiome research.
Topics: Animals; Chronic Disease; Disease Models, Animal; Humans; Inflammation; Microbiota; Paranasal Sinuses; Precision Medicine; Rhinitis; Sinusitis
PubMed: 32278449
DOI: 10.1016/j.iac.2019.12.009 -
American Family Physician Oct 2017Chronic rhinosinusitis is an inflammatory disease of the paranasal sinuses that occurs in 1% to 5% of the U.S. (Review)
Review
UNLABELLED
Chronic rhinosinusitis is an inflammatory disease of the paranasal sinuses that occurs in 1% to 5% of the U.S.
POPULATION
It may significantly decrease quality of life. Chronic rhinosinusitis is defined by the presence of at least two out of four cardinal symptoms (i.e., facial pain/pressure, hyposmia/anosmia, nasal drainage, and nasal obstruction) for at least 12 consecutive weeks, in addition to objective evidence. Objective evidence of chronic rhinosinusitis may be obtained on physical examination (anterior rhinoscopy, endoscopy) or radiography, preferably from sinus computed tomography. Treatment is directed at enhancing mucociliary clearance, improving sinus drainage/outflow, eradicating local infection and inflammation, and improving access for topical medications. First-line treatment is nasal saline irrigation and intranasal corticosteroid sprays. There may be a role for antibiotics in patients with evidence of an active, superimposed acute sinus infection. If medical management fails, endoscopic sinus surgery may be effective. Patients not responding to first-line medical therapy should be referred to an otolaryngologist, and selected patients with a history suggestive of other comorbidities (e.g., vasculitides, granulomatous diseases, cystic fibrosis, immunodeficiency) may also benefit from referral to an allergist or pulmonologist.
Topics: Administration, Intranasal; Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Chronic Disease; Female; Humans; Male; Nasal Sprays; Quality of Life; Rhinitis; Sinusitis; Sodium Chloride; Therapeutic Irrigation; United States
PubMed: 29094889
DOI: No ID Found -
Annual Review of Pathology Jan 2017Chronic rhinosinusitis (CRS) is a troublesome, chronic inflammatory disease that affects over 10% of the adult population, causing decreased quality of life, lost... (Review)
Review
Chronic rhinosinusitis (CRS) is a troublesome, chronic inflammatory disease that affects over 10% of the adult population, causing decreased quality of life, lost productivity, and lost time at work and leading to more than a million surgical interventions annually worldwide. The nose, paranasal sinuses, and associated lymphoid tissues play important roles in homeostasis and immunity, and CRS significantly impairs these normal functions. Pathogenic mechanisms of CRS have recently become the focus of intense investigations worldwide, and significant progress has been made. The two main forms of CRS that have been long recognized, with and without nasal polyps, are each now known to be heterogeneous, based on underlying mechanism, geographical location, and race. Loss of the immune barrier, including increased permeability of mucosal epithelium and reduced production of important antimicrobial substances and responses, is a common feature of many forms of CRS. One form of CRS with polyps found worldwide is driven by the cytokines IL-5 and IL-13 coming from Th2 cells, type 2 innate lymphoid cells, and probably mast cells. Type 2 cytokines activate inflammatory cells that are implicated in the pathogenic mechanism, including mast cells, basophils, and eosinophils. New classes of biological drugs that block the production or action of these cytokines are making important inroads toward new treatment paradigms in polypoid CRS.
Topics: Adult; Chronic Disease; Humans; Nasal Polyps; Rhinitis; Sinusitis
PubMed: 27959637
DOI: 10.1146/annurev-pathol-052016-100401 -
Clinical Anatomy (New York, N.Y.) Sep 2022The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated... (Review)
Review
The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated utilizing a number of different methods ranging from cadaveric analysis to modern cross sectional imaging with 3D modeling. An understanding of normal pediatric paranasal sinus embryology and development enables us to better determine when pathology may be affecting the normal developmental process. Cystic fibrosis, chronic sinusitis, deviated nasal septum and cleft lip and palate are some of the conditions which have been shown to effect paranasal sinus development to varying degrees. Functional endoscopic sinus surgery (FESS) is becoming increasingly common and an understanding of sinus anatomy together with when periods of rapid growth occur during childhood is important clinically. Although concerns have been raised regarding the impact of FESS on facial growth, there is limited evidence of this in regards to either changes in anthropomorphic measurements or clinical assessments of symmetry post operatively.
Topics: Child; Cleft Lip; Cleft Palate; Ethmoid Bone; Humans; Paranasal Sinuses; Sphenoid Sinus
PubMed: 35437820
DOI: 10.1002/ca.23888 -
The Journal of Allergy and Clinical... Jul 2022Chronic rhinosinusitis is characterized by persistent locoregional mucosal inflammation of the paranasal sinuses and upper airway that has substantial associated health... (Review)
Review
Chronic rhinosinusitis is characterized by persistent locoregional mucosal inflammation of the paranasal sinuses and upper airway that has substantial associated health care costs. Personalized approaches to care that incorporate use of molecular biomarkers, phenotypes, and inflammatory endotypes is a major focus of research at this time, and the concurrent rise of targeted therapeutics and biologic therapies has the potential to rapidly advance care and improve outcomes. Recent findings suggest that improved understanding of chronic rhinosinusitis phenotypic and endotypic heterogeneity, and incorporation of these characteristics into clinical care pathways, may facilitate more effective selection of surgical and/or therapeutic interventions. Ultimately, these personalized approaches have the potential to target specific inflammatory pathways, increase efficacy, reduce costs, and limit side effects. This review summarizes recent advances in the identification and characterization of chronic rhinosinusitis phenotypes, endotypes, and biomarkers and reviews potential implications for targeted therapeutics.
Topics: Biomarkers; Chronic Disease; Humans; Nasal Polyps; Phenotype; Rhinitis; Sinusitis
PubMed: 35469844
DOI: 10.1016/j.jaci.2022.04.013 -
European Annals of Otorhinolaryngology,... Feb 2018Chronic nasal dysfunction is a clinical concept in the diagnostic and therapeutic management of sinonasal diseases, based on the evo-devo theory of formation of the nose... (Review)
Review
Chronic nasal dysfunction is a clinical concept in the diagnostic and therapeutic management of sinonasal diseases, based on the evo-devo theory of formation of the nose according to which the nose is not a single organ but rather an association of three organs: olfactory nose, respiratory nose and paranasal sinuses. In chronic nasal dysfunction theory, etiological diagnosis takes account of the possible pathophysiological independence of nasal symptoms, in accordance with the different origins and physiology of the three organs constituting the nose. The diagnostic approach of the chronic nasal dysfunction concept breaks down the pathology so as to propose treatment(s) adapted to the diseased organ(s) and to the capacity for physiological resolution of dysfunction induced in one organ by pathology in a neighboring nasal organ. The ethmoid is not a sinus according to evo-devo, and therefore functional endoscopic endonasal surgery (FEES) cannot be restricted to functional endoscopic sinus surgery (FESS). Evo-devo theory and the chronic nasal dysfunction concept offer an alternative to the concept of chronic rhinosinusitis with or without polyps for the management of sinonasal diseases.
Topics: Chronic Disease; Humans; Laryngoscopy; Nasal Obstruction; Nasal Polyps; Nasal Surgical Procedures; Rhinitis; Sinusitis; Smell; Treatment Outcome
PubMed: 29249643
DOI: 10.1016/j.anorl.2017.11.006 -
Ceska a Slovenska Oftalmologie :... 2019Silent sinus syndrom is rare and slow progressive disorder associated with asymptomatic chronic maxillary sinusitis and collapse of the orbital floor. The most common...
Silent sinus syndrom is rare and slow progressive disorder associated with asymptomatic chronic maxillary sinusitis and collapse of the orbital floor. The most common manifestations are enophtalmos, hypoglobus and pseudoretraction upper eyelid. Silent sinus syndrome is almost a unilateral condition and is usually diagnosed in patients in their 30´s and 40´s. The largest risk factors is underlaying aberrant nasal anatomy. The subsequent osteomeatal complex obstruction leads to hypoventilation of the maxillary sinus and negative pressure development. The sinus cavity is filed with a combination of mucus and acellular transudate. This proces create a chronic mucosal inflammation with demineralization and collapse of the orbital floor. CT imaging is pathognomonic and shows ipsilateral maxilar sinusitis and the orbital floor is inferiorly displaced. The differential diagnosis includes chronic sinusitis, osteomyelitis, malignat sinus infiltration and orbital trauma. The endoscopic antrostomy is the gold standard to re-establish normal sinus aeration. In this article we describe patient with silent sinus syndrome, who has been treated at our clinic and his symptoms were corrected ad integrum after the surgery.
Topics: Humans; Maxillary Sinus; Maxillary Sinusitis; Paranasal Sinus Diseases; Syndrome
PubMed: 31238693
DOI: 10.31348/2018/6/5 -
Ear, Nose, & Throat Journal Jun 2020
Topics: Chronic Disease; Humans; Male; Medical Illustration; Middle Aged; Oroantral Fistula; Paranasal Sinuses; Rhinitis; Sinusitis
PubMed: 30966810
DOI: 10.1177/0145561319840536 -
Acta Clinica Croatica Oct 2022Chronic rhinosinusitis (CRS) is a widespread disease with various symptoms. It is defined as an inflammation of the nasal mucosa and paranasal sinuses lasting for 12...
Chronic rhinosinusitis (CRS) is a widespread disease with various symptoms. It is defined as an inflammation of the nasal mucosa and paranasal sinuses lasting for 12 weeks, with symptoms of nasal obstruction and/or congestion and facial pain and/or pressure as well as decreased sense of smell. Despite the widespread prevalence of the disease, the diagnosis and treatment of CRS are still not adequately developed, so many patients remain misdiagnosed. This study involved 150 patients who, according to EPOS guidelines, met the diagnosis of CRS without nasal polyposis. Each patient underwent a computerized tomography (CT) scan of the paranasal sinuses, which was evaluated according to the Lund-Mackay scoring system. Furthermore, patients completed a visual analog scale (VAS) score questionnaire which examined the severity of their symptoms. The aim of this study was to find an association between the degree of mucositis and the clinical symptoms reported by the patient. Our results showed a low positive correlation between nasal secretion and Lund-Mackay score for the bilateral ostiomeatal complex (OMC). Furthermore, a low positive correlation was found between the severity of reduced sense of smell and severity of anterior ethmoid and sphenoid sinusitis. The results demonstrated a low negative correlation between the severity of facial pain or pressure and the severity of inflammation of the anterior ethmoid and sphenoid sinus. The results of statistical testing did not show statistical differences in severity of subjective symptoms for almost all of the observed symptoms in persons with unilateral inflammation and persons without unilateral inflammation, except for cough. People who did not have unilateral inflammation had a more pronounced cough compared with people who had unilateral inflammation. However, these correlations were very mild and not clinically significant, so we cannot say that the distribution of sinusitis significantly affects the occurrence of characteristic symptoms in chronic rhinosinusitis.
Topics: Humans; Cough; Rhinitis; Sinusitis; Chronic Disease; Inflammation; Facial Pain
PubMed: 37250669
DOI: 10.20471/acc.2022.61.s4.8