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Rhinosinusitis and Lacrimal Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Inflammation of <12 weeks’ duration is acute rhinosinusitis (with symptom-free intervals if it is recurrent). Severity can be assessed by rating on a visual analogue scale from 1 (not troublesome) to 10 (worst): 1–3 is mild, 4–7 is moderate, and 8–10 is severe.
Nasal problems in the athlete
Published in John W. Dickinson, James H. Hull, Complete Guide to Respiratory Care in Athletes, 2020
Acute rhinosinusitis is most frequently the result of viral infection, predominantly rhinovirus (i.e. the common cold virus). Chronic rhinosinusitis, where symptoms last longer than 12 weeks, is generally divided into cases with (CRSwNP) and without nasal polyps (CRSsNP).
Otorhinolaryngology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Chris Jephson, C. Martin Bailey
This is an inflammation of the nose and paranasal sinuses characterised by nasal congestion and one or more of discharge, facial pain or pressure and loss of smell. Acute rhinosinusitis is an infection with complete resolution of symptoms in less than 12 weeks. Chronic rhinosinusitis is associated with low-grade symptoms present for over 12 weeks.
Current and emerging treatment modalities for bacterial rhinosinusitis in adults: a comprehensive review
Published in Expert Opinion on Pharmacotherapy, 2022
Maria Gabriella Matera, Barbara Rinaldi, Vito de Novellis, Paola Rogliani, Mario Cazzola
To avoid needless antibacterial therapy, it is crucial to distinguish between ARS caused by viral upper respiratory infections and ARS caused by bacteria [2]. Additionally, this assists the physician in avoiding requesting superfluous diagnostic procedures, which lowers costs and raises the standard of treatment. The physician must suspect the presence of ABRS when the symptoms or signs of ARS (purulent nasal drainage combined with nasal obstruction, sinus pressure, pain, and fullness) continue for at least 10 days after the beginning of upper respiratory symptoms or worsen within 10 days following an initial improvement [2]. The American Academy of Otolaryngology – Head and Neck Surgery Foundation guideline update group stated, ‘A clinician should diagnose acute bacterial rhinosinusitis when symptoms or signs of acute rhinosinusitis persist without evidence of improvement for at least 10 days beyond the onset of upper respiratory symptoms’ [2].
What are the challenges in choosing pharmacotherapy for rhinosinusitis?
Published in Expert Opinion on Pharmacotherapy, 2020
Alkis J Psaltis, Erich Vyskocil
Despite the similar clinical manifestations of acute and chronic rhinosinusitis, the underlying pathophysiology and treatments of the two conditions are different. Acute rhinosinusitis is a pathogen-driven disease while chronic rhinosinusitis has a more complex and multifactorial etiology. Given that the majority of patients with ARS have an underlying viral etiology, treatment should remain supportive with the use of analgesia, saline sprays, and intranasal corticosteroids. Although there is little evidence to support the use of oral or topical decongestants, short-term use of these agents may lessen the intense nasal obstruction some individuals experience with ARS. Antibiotic use should be discouraged unless patients have evidence of complications, show worsening of their clinical picture after 5 days or have a protracted course lasting more than 7–10 days. If antibiotics are considered, B-lactam antibiotics will typically cover most upper airway pathogens and can be prescribed empirically without the need for bacterial cultures unless clinically indicated. Investigations are not typically required unless complications are suspected or patients fail to improve.
Current healthcare pathways in the treatment of rhinosinusitis in Germany
Published in Acta Oto-Laryngologica, 2018
Jonas Jae-Hyun Park, Claus Bachert, Stefan Dazert, Karel Kostev, David Ulrich Seidel
Every year, a large percentage of the world’s population is diagnosed with acute rhinosinusitis (ARS), which is mostly caused by viral infection with or without bacterial superinfection of the mucosa of the paranasal sinuses [1]. In cases that persist for more than 2–3 months, a diagnosis of chronic sinusitis (CS) is made [2]. Chronic rhinosinusitis (CRS) is epidemiologically important, as it affects over 10% of the European adult population [3,4]. Because of its epidemiological relevance, CRS is a common health problem with significant direct medical costs [5]. For example, a U.S. study conducted in 2003, which analyzed the healthcare data of more than 300,000 U.S. employees, found sinusitis to be one of the ten medical conditions with the highest health and productivity cost burden, along with other conditions such as back pain, arterial hypertension, diabetes mellitus, chronic obstructive pulmonary disease, and myocardial infarction [6]. Therefore, given its epidemiology and significant economic impact, rhinosinusitis is a disease that deserves to be further analyzed from a systematic, public healthcare perspective.