Adult Sinusitis

Publication Date: April 1, 2015

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)

...ired images of the right middle mea...

Figure 2. Endoscopic image of edema in the right middle meatus (needle tip points to the apex of the middle turbinate)

...oscopic image of edema in the righ...

Figure 3. Paired Images

...re 3. Paired Images...

Table 1. Rhinosinusitis Definitions

...1. Rhinosinusitis DefinitionsHaving trouble v...

Diagnosis

...iagnosis

...4. Symptom Prevalence by Day for Rhinov...


...ble 2. Comparison of Modalities for Objecti...


Treatment

Treatmen...

...gical management of CRS is not discussed in this...

...Symptomatic relief of VRSClinicians may recommend...


...mary of Key Action Statements (KAS)...

...al diagnosisClinicians should distinguish pres...

...aphic imaging and ARSClinicians should NOT obt...

...matic relief of VRSClinicians may recommend analg...

...tic relief of ABRSClinicians may rec...

...Initial management of ABRSClinicians s...

...ntibiotic for ABRSbIf a decision is m...

...atment failure for ABRSIf the patien...

...a. Diagnosis of CRS or recurrent ARSClini...

.... Objective confirmation of a diagnosis of CRS...

...ing factorsClinicians should assess t...

...Testing for allergy and immune functionClinicians...

10. CRS with polypsClinicians shou...

...ntranasal therapy for CRSClinicians...

...therapy for CRSClinicians should NO...

...atchful waiting can be implemented using a WAS...


...ure 5. Adult with Possible Sinusitis Clinician...


...ctors That Would Prompt Clinicians to Consider...


...5. Patient Instructions for Optimal U...


...able 6. Patient Information Sheet on Diag...


...ble 7. Patient Information Sheet on Treati...