AAAAI, ACAAI identify new recommendations for sinusitis diagnosis and managementNovember 30, 2005Sinusitis is one of the most diagnosed diseases in the United States, affecting approximately 16% of the adult population, and is responsible for nearly $5.8 billion in health care costs annually, according to an updated practice parameter. The Diagnosis and Management of Sinusitis: A Practice Parameter Update is featured in the December 2005 issue of the Journal of Allergy & Clinical Immunology (JACI) and is currently available on the JACI's Web site at www.jacionline.org. The JACI is the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI). The practice parameter provides an updated definition of sinusitis and new recommendations for the diagnosis and management of sinusitis, including predisposing factors, antibiotic use, when to see a specialist, and other diseases associated with sinusitis. "This practice parameter is intended to improve on the diagnosis and management of patients," said Raymond G. Slavin, MD, MS, FAAAAI, and lead author of the updated practice parameter. "This will result in reduced health care costs, and a better quality of life for patients with sinusitis." Sinusitis is an inflammation of one or more of the paranasal sinuses, and can be divided into acute, subacute, chronic and recurrent. The classifications are based on how long symptoms last, the specific sinus involved, or both. The updated classification is as follows: - Acute sinusitis: symptoms for less than 4 weeks consisting of some or all of the following: persistent symptoms of an upper respiratory tract infection, purulent rhinorrhea, postnasal drainage, anosmia, nasal congestion, facial pain, headache, fever, cough, and purulent discharge. - Subacute sinusitis: symptoms from four to eight weeks. - Chronic sinusitis: symptoms for eight weeks or longer of varying severity consisting of the same symptoms as seen in acute sinusitis. In chronic sinusitis there should be abnormal findings on CT or MRI. Some patients with chronic sinusitis might present with vague or insidious symptoms. - Recurrent sinusitis: three or more episodes of acute sinusitis per year. Patients with recurrent sinusitis might be infected by different organisms at different times. The two most common predisposing conditions to developing sinusitis are viral upper respiratory tract infections and allergic rhinitis. Allergic rhinitis is one of the most common chronic diseases, affecting up to 35.9 million Americans annually. The diagnosis of sinusitis is based on a combination of clinical history, physical examination, imaging studies, and/or laboratory tests. The Diagnosis and Management of Sinusitis: A Practice Parameter Update recommends: - The diagnosis of acute sinusitis should be primarily based on the history and physical examination of the patient. Imaging techniques such as radiographs or CT scans are not necessary. - Antibiotics should be withheld for 10 to 14 days, unless severe symptoms develop such as fever, facial pain or tenderness, or swelling around the eye. - The primary therapy for acute bacterial sinusitis is antibiotics, but with increasing resistance to penicillin being reported, alternative antibiotics may be necessary. - Referral to an allergist/immunologist, particularly for patients with chronic or recurrent sinusitis associated with certain conditions, and in patients who have undergone prior surgical procedures and continue to experience sinusitis. - Surgery is a consideration only after medical therapy has failed. According to the practice parameter and the AAAAI, referral to an allergist/immunologist should be sought when: - The patient suffers chronic, recurrent infectious or fungal rhinosinusitis. - There is a need to clarify whether an allergic or immune deficiency condition is playing a role. - If the sinusitis does not respond to the usual antibiotic treatment. - If the sinusitis significantly affects performance and quality of life. - The sinusitis co-exists with allergic rhinitis. Working with an allergist/immunologist, the best qualified medical professional trained to manage the prevention, diagnosis and treatment of sinusitis and other allergic diseases, will demonstrate improved outcomes and quality of life for people suffering from allergic disease. American Academy of Allergy, Asthma & Immunology |
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| Related Sinusitis Current Events and Sinusitis News Articles Johns Hopkins researchers track down protein responsible for chronic rhinosinusitis with polyps A protein known to stimulate blood vessel growth has now been found to be responsible for the cell overgrowth in the development of polyps that characterize one of the most severe forms of sinusitis, a study by Johns Hopkins researchers suggests. Patients with chronic rhinosinusitis have increased incidence of other chronic illnesses Patients who suffer from chronic rhinosinusitis (CRS) also tend to suffer from other chronic illnesses, like asthma, hypertension, and arthritis. Safety, efficacy of corneal transplant procedure confirmed; an antibiotic can cause double vision Highlights of September's Ophthalmology, the journal of the American Academy of Ophthalmology (Academy), include a 2009 review by the Academy of the safety and efficacy of a widely used corneal transplant procedure and a warning about an unusual but serious reaction to systemic fluroquinolones, a class of antibiotics used to treat a variety of bacterial infections. Misuse of common antibiotic is creating resistant TB Use of a common antibiotic may be undercutting its utility as a first-line defense against drug-resistant tuberculosis (TB). Fluoroquinolones are the most commonly prescribed class of antibiotics in the U.S. and are used to fight a number of different infections such as sinusitis and pneumonia. Waist size and body mass index are risk factors for sleep disordered breathing in children A study in the June 1 issue of the journal SLEEP found that waist circumference and body mass index (BMI) are consistent, independent risk factors for all severity levels of sleep disordered breathing (SDB) in children, suggesting that as with adult SDB, metabolic factors are important risk factors for childhood SDB. Of Mice and Peanuts: A new mouse model for peanut allergy Chicago researchers report the development of a new mouse model for food allergy that mimics symptoms generated during a human allergic reaction to peanuts. Is ineffective esophageal motility associated with gastropharyngeal reflux disease? IEM is associated with an increased acid clearance times in the distal esophagus. Gastropharyngeal reflux causes supraesophageal manifestations such as globus, chronic cough, hoarseness, asthma, chronic sinusitis, or other otorhinolaryngologic diseases. Sinusitis patients have pain similar to the elderly and people with arthritis A new analysis led by researchers at Georgetown University Medical Center suggests many patients with sinusitis have aches and pains similar in severity to people in their 80s and those with arthritis or depression. Retail medical clinics attract patients who do not have regular health care providers Retail medical clinics located in pharmacies and other stores typically attract insured and uninsured patients who are seeking help for a small group of easy-to-treat illnesses or preventive care and do not otherwise have a regular health care provider, according to a new RAND Corporation study. Innate immune system targets asthma-linked fungus for destruction A new study shows that the innate immune system of humans is capable of killing a fungus linked to airway inflammation, chronic rhinosinusitis and bronchial asthma. More Sinusitis Current Events and Sinusitis News Articles |
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