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)
...1. Paired images of the right midd...
Figure 2. Endoscopic image of edema in the right middle meatus (needle tip points to the apex of the middle turbinate)
...ndoscopic image of edema in the right mid...
Figure 3. Paired Images
...re 3. Paired Images...
Table 1. Rhinosinusitis Definitions
...inusitis DefinitionsHaving trouble...
Diagnosis
Diagnosis
...igure 4. Symptom Prevalence by Day...
...ison of Modalities for Objective Confirmation of...
Treatment
...atment...
...cal management of CRS is not discussed in this gu...
...ptomatic relief of VRSClinicians may recomm...
...le 3. Summary of Key Action Stateme...
1a. Differential diagnosisClinicians should dist...
...Radiographic imaging and ARSClinicia...
...ptomatic relief of VRSClinicians may recommend ana...
...ymptomatic relief of ABRSClinicians may rec...
...tial management of ABRSClinicians should...
...antibiotic for ABRSbIf a decision is mad...
...ent failure for ABRSIf the patient worsens or fai...
...sis of CRS or recurrent ARSClinicians should di...
...nfirmation of a diagnosis of CRSClinician...
...Modifying factorsClinicians should...
...or allergy and immune functionClinicia...
...with polypsClinicians should confirm...
...cal intranasal therapy for CRSClin...
.... Antifungal therapy for CRSClinicians should NO...
...Watchful waiting can be implemente...
...lt with Possible Sinusitis Clinician judgment a...
...That Would Prompt Clinicians to Consi...
...5. Patient Instructions for Optimal Use...
...tient Information Sheet on Diagnosis of Acute...
...ble 7. Patient Information Sheet on Treating Acute...