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OTORINOLARINGOLOGIA

A Journal on Otorhinolaryngology, Head and Neck Surgery,
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Otorinolaringologia 2006 September;56(3):117-25

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Chronic rhinosinusitis, a review of current pathophysiological concepts and evidence based medical therapy

Cervin A.

Department of Otolaryngology Head and Neck Surgery, Lund University Lund University Hospital and Helsingborg Hospital, Sweden


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Chronic rhinosinusitis is not a diagnosis per se, but a group of diseases characterized by inflammation in the sinu-nasal mucosa with a duration of at least 12 weeks. The diagnosis is a clinical one with symptoms of facial pain and or headache, nasal secretion and obstruction, reduced sense of smell and often fatigue. Symptoms should be verified with nasal endoscopy with findings of mucosal oedema, inflammation and increased secretion. However predisposing diseases such as dental infection, asthma, allergy, cystic fibrosis, primary ciliary dyskinesia and immunodeficiency should be evaluated. In choosing therapy one has to decide whether the disease is dominated by inflammation (steroid treatment) or infection (antibiotic treatment). Often the clinician will find a mix of both. A problem is the lack of placebo-controlled trials supporting treatment recommendations. However, the mainstay in the treatment is still antibiotic therapy and systemic or topical steroids supplemented by nasal saline lavage. Adequate medical therapy should always be tried before surgery is considered, except in unilateral disease where surgery is the first treatment option.

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