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19/02/2014, 08:20
... Cough
Earpain/pressure/fullness
*Facialpain/pressurealonedoesnotconstituteasuggestivehistoryforchronicrhinosinusitisintheabsenceof
another
majornasalsymptomorsign
NASALBLOCKAGE
Nasalblockagehasmany causes. Itisconvenienttodividetheminto causes thataretreate dmedically and
causes thatrequiresurgical treatment. Medical causes includethecommoncold(viralinfection—atemporary
cause),bacterialsinusitis,allergy,sensitivitytodust, ... smoke,pollution, and other
irritants.Surgical causes include
anatomicabnormalitiessuchasadeviatedseptum,nasalpolyps,obstructedsinusesthatdonotimprovewith
medication,over‐enlargedturbinates,obstructingadenoids, and other causes. Sometimesscarringfromtraumaor
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Allergic and Non‐AllergicSinusitisforthePrimaryCarePhysician:
Pathophysiology,Evaluation and Treatment
CHAPTER3
QUESTIONS
1.Astronghistoryconsistentwithadiagnosisofchronicsinusitisincludesthepresenceof:
A. ... arance.”
Rhinology.
2006;44(3):193‐6.
23.BoatsmanJ,CalhounK,RyanM.“RelationshipBetweenRhinosinusitis Symptoms and MucociliaryClearance
Time.”OtolaryngolHeadNeckSurg.2006;134(3):491‐493.
24.BeckerDG.Septoplasty and TurbinateSurgery.AestheticSurgJ2003;23:393‐403.
25.CookPR,BegegniA,BryantC,DavisWE.Effectofpartialmiddleturbinectomyon
nasalairflow and resistance.
OtolaryngolHeadNeckSurg1995;113:413‐419.
26.PankeyGA,GrossCW,MendelsohnMG.ContemporaryDiagnosis and ManagementofSinusitis.NewtownPA:
HandbooksinHealthCare,2000.
27.FacerGW,KernEB.Sinusitis:currentconcepts and management.In:BaileyBJ,editor.Head and NeckSurgery–
Otolaryngology.Philadelphia,PA:
JBLippincott,1993.
28.ReulerJB,LucasLM,KumarKL.Sinusitis.Areviewforgeneralists.WestJMed1995;163:40–48.
29.StammbergerH.FunctionalEndoscopicSinusSurgery.Philadelphia,PA:BCDecker,1991.
19
Allergic and Non‐AllergicSinusitisforthePrimaryCarePhysician:
Pathophysiology,Evaluation and Treatment
CHAPTER2
SIGNS AND SYMPTOMS OFSINUSDISEASE
SinusitisisoneofthemostcommonhealthcarecomplaintsintheUnitedStates.(1‐8)Approximately1in8
peopleintheUnitedStateswillhavesinusitisatonetimeintheirlives.TheNationalCenterforDiseaseStatistics
reports
thatsinusitisisnowthenumberonechronicillnessforallagegroupsintheUnitedStates.The1993National
HealthInterviewSurveyfoundthatsinusitiswasthemostcommonlyreportedchronicdisease,affecting
approximately14%oftheUnitedStatespopulation, and Anandreporteda16%incidenceinhis2004
study.(9)A
2006studybyKoy and Coonsontheincidenceofchronicconditionsreportedthatapproximatelythree‐fifths
(62.5%)ofthestudysamplereportedatleastoneof18chronicmedicalconditions;sinusitis(24.8%)wasthemost
commonlyreportedcondition,followedbyhypertension(23.5%) and arthritis(21.5%).(
10)
Sinusdiseaseaffectsroughly31millionpeopleannually.Furthermore,10%ofthepopulationsuffersfrom
allergicsinusdisease.Between1990 and 1992,reportsindicatedthatsinusitissufferershadapproximately73
milliondaysofrestrictedactivity—a50%increasefrom4yearsearlier.Sinusitisaccountedfornearly25million
physicianoffice
visitsintheUnitedStatesin1993 and 1994.(Ofcourse,manymorecasesareunreported, and many
patientssufferwithoutseeingaphysician,sothetrueincidenceofsinusitisisunknown.)Althoughtheyaretypically
notserious and respondpromptlytopropermedical treatment, inflammatorydiseasesofthesinusesare
aleading
causeoflossofproductivitybothatwork and atschool.
RhinosinusitisposesanimmenseeconomicburdenintheUnitedStates.(9)Thecostoftreatingsinus
diseaserunsintothebillionsofdollars,withouttakingintoaccountlossofwork.Overallhealthcareexpenditures
attributableto
sinusitisin1996wereestimatedat$5...