Sinusitis

This chapter discusses the background, prevention, diagnosis, treatment, and prognosis for sinusitis. Rhinosinusitis encompasses a broad range of diseases characterized by inflammation of paranasal sinuses. The diagnosis of rhinosinusitis is based on subjective and objective findings and depends on the duration of symptoms. Rhinosinusitis affects millions of people in the United States annually, or 15.2% of the population each year. The burden of disease includes lost workdays, increased health care costs, and increased doctor's visits. The accurate diagnosis of acute, recurrent acute, subacute, and chronic rhinosinusitis depends on symptoms, the duration of symptoms, and disease progression. The physical examination is helpful in detecting possible intracranial or ocular complications, and endoscopy is helpful for confirmation of diagnosis. The mainstay of treatment of acute rhinosinusitis is supportive, with the addition of antibiotics, but for chronic rhinosinusitis treatment may require more adjunctive medications and possibly surgery.