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PMID: 21490181 Published · ppublish English Journal Article Review

Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines.

Mayo Clinic proceedings ·Vol. 86 ·No. 5 ·2011-05-00 ·Pages 427-43

Meltzer EO, Hamilos DL

Abstract

Rhinosinusitis (RS) affects approximately 1 in 7 adults in the United States, and its effect on quality of life, productivity, and finances is substantial. During the past 10 years, several expert panels from authoritative bodies have published evidence-based guidelines for the diagnosis and management of RS and its subtypes, including acute viral RS, acute bacterial RS, chronic RS (CRS) without nasal polyposis, CRS with nasal polyposis, and allergic fungal RS. This review examines and compares the recommendations of the Rhinosinusitis Initiative, the Joint Task Force on Practice Parameters, the Clinical Practice Guideline: Adult Sinusitis, the European Position Paper on Rhinosinusitis and Nasal Polyps 2007, and the British Society for Allergy and Clinical Immunology. Points of consensus and divergent opinions expressed in these guidelines regarding classification, diagnosis, and management of adults with acute RS (ARS) and CRS and their various subtypes are highlighted for the practicing clinician. Key points of agreement regarding therapy in the guidelines for ARS include the efficacy of symptomatic treatment, such as intranasal corticosteroids, and the importance of reducing the unnecessary use of antibiotics in ARS; however, guidelines do not agree precisely regarding when antibiotics should be considered as a reasonable treatment strategy. Although the guidelines diverge markedly on the management of CRS, the diagnostic utility of nasal airway examination is acknowledged by all. Important and relevant data from MEDLINE-indexed articles published since the most recent guidelines were issued are also considered, and needs for future research are discussed.

MeSH Terms
Acute Disease Administration, Intranasal Administration, Oral Adrenal Cortex Hormones/administration & dosage Anti-Bacterial Agents/administration & dosage Chronic Disease Clinical Trials as Topic Evidence-Based Medicine Histamine Antagonists/administration & dosage Humans Practice Guidelines as Topic Practice Patterns, Physicians'/statistics & numerical data Quality of Life Rhinitis/diagnosis,drug therapy,epidemiology Sinusitis/diagnosis,drug therapy,epidemiology Sodium Chloride/administration & dosage United States/epidemiology
Chemicals
Adrenal Cortex Hormones Anti-Bacterial Agents Histamine Antagonists Sodium Chloride
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Meltzer Eli O
Allergy and Asthma Medical Group and Research Center, 9610 Granite Ridge Dr, Ste B, San Diego, CA 92123, USA. [email protected]
Hamilos Daniel L
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Article Info
Journal
Mayo Clinic proceedings
Abbr.
Mayo Clin Proc
ISSN
1942-5546
DOI
10.4065/mcp.2010.0392
Email
[email protected]
Published
2011-05-00
Epub
2011-00-13
Pages
427-43
Language
English
Region
England
NLM ID
0405543
PMCID
PMC3084646
Subset
IM
External Links
PubMed source DOI: 10.4065/mcp.2010.0392 PMC Full Text View journal details
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