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Chronic sinusitis: an update
1Harvard Community Health Plan of New England, Providence, Rhode Island.
American Family Physician
|May 1, 1992
Summary
Accurate patient history is key for diagnosing chronic sinusitis, a condition causing facial pain and congestion. Treatment typically involves antibiotics, decongestants, and steroids, with surgery as a last resort.
Area of Science:
- Otolaryngology
- Rhinosinusitis Research
Background:
- Chronic sinusitis diagnosis relies heavily on patient history.
- Classic symptoms include facial pain, nasal congestion, and postnasal drip.
- Certain symptoms like fever and purulent discharge are uncommon.
Purpose of the Study:
- To outline the diagnostic process for chronic sinusitis.
- To review the effectiveness of various diagnostic tools.
- To discuss treatment modalities for chronic sinusitis.
Main Methods:
- Clinical history taking is paramount.
- Fiberoptic nasopharyngoscopy aids in identifying discharge sources and obstruction.
- Computed tomographic (CT) scanning offers superior sinus imaging compared to plain radiographs.
Main Results:
- Physical examination methods like palpation and transillumination have limited diagnostic value.
- CT scans provide better visualization of sinuses for chronic sinusitis.
- Prolonged antibiotic therapy combined with decongestants and steroids is often effective.
Conclusions:
- Accurate history and CT imaging are crucial for diagnosing chronic sinusitis.
- Medical management with antibiotics, decongestants, and steroids is the primary treatment.
- Surgical intervention is reserved for refractory cases.