Adult Sinusitis
Key Points
Key Points
- Sinusitis affects about 1 in 8 adults in the United States, resulting in over 30 million annual diagnoses.
- More than 1 in 5 antibiotics prescribed in adults are for sinusitis, making it the fifth most common diagnosis responsible for antibiotic therapy.
- About 20 million cases of presumed acute bacterial rhinosinusitis (ABRS) occur annually in the United States, rendering it one of the most common conditions encountered by clinicians.
- The importance of ABRS relates not only to prevalence, but to the potential for uncommon but serious complications that include meningitis, brain abscess, orbital cellulitis and orbital abscess.
Figure 1. Paired images of the right middle meatus in artist’s view (left) and endoscopic view (right)
...gure 1. Paired images of the right middle meat...
Figure 2. Endoscopic image of edema in the right middle meatus (needle tip points to the apex of the middle turbinate)
...scopic image of edema in the right middle meatus (...
Figure 3. Paired Images
...3. Paired Images...
Table 1. Rhinosinusitis Definitions
...1. Rhinosinusitis DefinitionsTerm and Defin...
Diagnosis
...Dia...
Figure 4. Symptom Prevalence by Day for Rhi...
...2. Comparison of Modalities for Objective Confir...
Treatment
...Treatme...
...l management of CRS is not discussed in this...
...omatic relief of VRSClinicians may recommend...
...Table 3...
...diagnosisClinicians should distinguish presumed A...
.... Radiographic imaging and ARSClinicians should...
...c relief of VRSClinicians may recom...
...ic relief of ABRSClinicians may recommend analgesi...
...anagement of ABRSClinicians should eithe...
5. Choice of antibiotic for ABRSbIf a decisi...
...Treatment failure for ABRSIf the patient...
...of CRS or recurrent ARSClinicians should dist...
...ve confirmation of a diagnosis of CRSCli...
...actorsClinicians should assess the patient with CR...
...esting for allergy and immune functionClinic...
...th polypsClinicians should confirm the presence...
...Topical intranasal therapy for CRSClinicians...
...al therapy for CRSClinicians should N...
a Watchful waiting can be implemented us...
...igure 5. Adult with Possible Sinusit...
...4. Factors That Would Prompt Clinicians to Con...
.... Patient Instructions for Optimal Use...
...t Information Sheet on Diagnosis of Acute...
...ient Information Sheet on Treating Acute Bacteria...