Chronic sinusitis without nasal polyps - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Chronic rhinosinusitis is inflammation of the paranasal sinuses lasting more than 12 weeks.
Diagnosis is initially clinical. Nasal endoscopy may show inflammation, purulent discharge, edema, or frank polyps.
Initial medical treatment includes nasal saline irrigation and topical intranasal corticosteroids. Oral antibiotics, oral corticosteroids, antihistamines, and leukotriene receptor antagonists may also be considered.
Computed tomography is needed if initial medical treatment fails.
Functional endoscopic sinus surgery is very effective for patients unresponsive to medical treatment.

Quick Reference

History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Pre-op planning at a surgical navigation workstation
Image-guided endoscopic sinus surgery using an optical-based surgical navigation system
Pre-op planning at a surgical navigation workstation
Image-guided endoscopic sinus surgery using an optical-based surgical navigation system

Citations

Key Articles

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-S39.[Abstract][Full Text]
Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.[Abstract]
Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020 Feb 20;58(suppl s29):1-464.[Abstract]

Referenced Articles

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21. Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.[Abstract]
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28. Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol. 2020 Oct;146(4):721-767.[Abstract][Full Text]
29. Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020 Feb 20;58(suppl s29):1-464.[Abstract]
30. Mösges R, Heubach CP. What is the evidence for non-antibiotic drug therapy of rhinosinusitis? Laryngorhinootologie. 2011 Dec;90(12):740-6.[Abstract]
31. Chong LY, Head K, Hopkins C, et al. Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016 Apr 26;(4):CD011996.[Abstract][Full Text]
32. Chong LY, Head K, Hopkins C, et al. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016 Apr 26;(4):CD011993.[Abstract][Full Text]
33. Wang C, Lou H, Wang X, et al. Effect of budesonide transnasal nebulization in patients with eosinophilic chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2015 Apr;135(4):922-29.[Abstract][Full Text]
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36. Soler ZM, Oyer SL, Kern RC, et al. Antimicrobials and chronic rhinosinusitis with or without polyposis in adults: an evidenced-based review with recommendations. Int Forum Allergy Rhinol. 2013 Jan;3(1):31-47.[Abstract]
37. Head K, Chong LY, Piromchai P, et al. Systemic and topical antibiotics for chronic rhinosinusitis. Cochrane Database Syst Rev. 2016 Apr 26;(4):CD011994.[Abstract][Full Text]
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52. Taghi AS, Khalil SS, Mace AD, et al. Balloon sinuplasty: balloon-catheter dilation of paranasal sinus ostia for chronic rhinosinusitis. Expert Rev Med Devices. 2009 Jul;6(4):377-82.[Abstract]
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56. Smith TL, Singh A, Luong A, et al. Randomized controlled trial of a bioabsorbable steroid-releasing implant in the frontal sinus opening. Laryngoscope. 2016 Dec;126(12):2659-64.[Abstract][Full Text]
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60. Sindwani R, Han JK, Soteres DF, et al. NAVIGATE I: randomized, placebo-controlled, double-blind trial of the exhalation delivery system with fluticasone for chronic rhinosinusitis with nasal polyps. Am J Rhinol Allergy. 2019 Jan;33(1):69-82.[Abstract][Full Text]
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