Sinusitis and its management

Ah‐See, Kim; Evans, Andrew

doi:10.1136/bmj.39092.679722.be

Cited by 71 publications

(65 citation statements)

References 14 publications

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“…Presenting symptoms of CRS can include facial pain, headache, rhinorrhea, hyposmia, and dental pain. 1 Chronic rhinosinusitis is highly prevalent with an estimated 1 in 7 people affected in North America. 2,3 The annual cost to the American health care system is estimated at $5.8 billion US.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Association of CPAP Bacterial Colonization with Chronic Rhinosinusitis

Chin

George²,

Lannigan³

et al. 2013

Journal of Clinical Sleep Medicine

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Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Association of CPAP Bacterial Colonization with Chronic Rhinosinusitis

Chin

George²,

Lannigan³

et al. 2013

Journal of Clinical Sleep Medicine

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“…61,79 Patients with sinusitis complain of acute facial pain or pressure-type HAs and may present with nasal congestion, reduced sense of smell, postnasal drip, fever or malaise, and aching teeth associated with certain weather conditions or times of the year. 4 Referral to an ear, nose, and throat specialist or primary care physician will help clarify this common diagnosis.Patients with eye disorders may experience pain around the eye, numbness, HA, and other symptoms similar to TMD, cervicogenic HA, or primary HA. Optic neuritis, sometimes associated with multiple sclerosis, produces ocular pain with eye movement and may result in progressive acute monocular vision loss.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

A Proposed Diagnostic Classification of Patients With Temporomandibular Disorders: Implications for Physical Therapists

Harrison¹,

Thorp²,

Ritzline³

2014

J Orthop Sports Phys Ther

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Researchers and expert clinicians in orofacial pain have long acknowledged the Differential DiagnosisIn addition to the musculoskeletal structures (TMJ and the masticatory muscles) and the psychological factors discussed, orofacial pain may result from or be exacerbated by (1) primary HAs (migraine, cluster, tension type, other primary); (2) secondary HAs related to systemic problems such as cardiovascular and rheumatoid disorders and disorders related to the cervical spine, ears, sinuses, eyes, medications, and dental structures; and (3) cranial and peripheral neuralgias and central nervous system disorders.The following provides an overview of the physical therapy examination for people presenting with HAs and/or orofacial pain. The examination will consist of the history, screens for contributing psychological factors, a systems screen, cervical spine screen, and specific examination of the TMJ and masticatory muscles. PHYSICAL THERAPY EXAMINATION HistoryA thorough history will help identify the possible source(s) of the orofacial pain and provide a screen for other causative or contributing factors. 17,22,61,74,75 Red flags related to cardiac history (eg, angina or history of myocardial infarction) and brain function (eg, sudden-onset severe HAs, weakness, or slurred speech) must be investigated early in the history taking. Information about the nature of the pain will be critical in determining the possibility of primary HAs (migraine, cluster) (TABLE 3) and secondary HAs related to the eyes, ears, sinus, dental structures, medication complications, and/or neurologic types of pain. Unrelenting pain unrelated to musculoskeletal function is an indication for referral. Information about cervical dysfunction is essential to determine whether the cervical spine is causing or exacerbating the HA/facial pain. Medication history is important to determine potential negative interactions, rebound HAs from overuse (as occurs with nonsteroidal anti-inflammatory drugs), or withdrawal.Key questions have been examined and determined to have strong sensitivity and specificity in incriminating TMDs as the source of pain. 22,29 The initiating question is, "Have you had pain or stiffness in the face, jaw, temple, in front of the ear, or in the ear in the past month?" A positive response should be followed with a question about whether the symptoms are altered by any of the following jaw activities: chewing, talking, singing, yawning, kissing, moving the jaw. 22,29,74,75 The other key inquiry is directed toward identifying the presence of a disc displacement 22,74 : "Have you ever had your jaw lock or catch so that it would not open all the way? If so, was this limitation in jaw opening severe enough to interfere with your ability to eat? Have you ever noticed clicking, popping, or other sounds in your joint?" 74 importance of the psychological domain in causing and/or maintaining pain, and in upregulating peripheral and central neural structures involved in nociception. 22,32,74,75 Central nervous system differences in the t...

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“…The first choice treatment in the management of CRS is local steroids. 1,2 In a cross-sectional study covering 174 GPs from 89 general practices in the Netherlands, 50% of antibiotic prescriptions were prescribed for respiratory disorders. 5,6 Twenty-two percent of the antibiotics for respiratory tract infections (RTIs) were prescribed for rhinosinusitis.…”

Section: Introductionmentioning

confidence: 99%

“…ARS can be divided into two groups: common cold/acute viral rhinosinusitis (symptoms disappear in less than 10 days); and acute non-viral/bacterial rhinosinusitis (increase of symptoms after five days or persistent symptoms after 10 days). [1][2][3] In the Netherlands, general practitioners (GPs) generally use the rhinosinusitis management guidelines from the Dutch College of General Practitioners 4 which does not distinguish between ARS and CRS. Treatment is based on the severity of symptoms and the risk of developing complications.…”

Section: Introductionmentioning

confidence: 99%

Management of rhinosinusitis in Dutch general practice

Hoffmans

Schermer

Weel

et al. 2011

Primary Care Respiratory Journal

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Aims: To determine whether general practitioners (GPs) distinguish between the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS), especially with regard to prescription of antibiotics and nasal steroids.Methods: A questionnaire on the management of rhinosinusitis was sent to 1000 GPs in the Netherlands.Results: Ninety-six percent discriminated between ARS and CRS. However, the definition of ARS and CRS varied. The percentage of GPs prescribing antibiotics rose as rhinosinusitis severity increased. The prescription rate of nasal corticosteroids was highest for CRS (88.6%). Prescribing nasal corticosteroids in ARS was not very common.Conclusions: Most GPs discriminate between ARS and CRS and 54% accepted (the EP3OS-defined) 12 weeks as the division between ARS and CRS. Antibiotics and nasal steroids are commonly used agents, but the management of rhinosinusitis is not always consistent with guidelines.

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Sinusitis and its management

Cited by 71 publications

References 14 publications

Association of CPAP Bacterial Colonization with Chronic Rhinosinusitis

Association of CPAP Bacterial Colonization with Chronic Rhinosinusitis

A Proposed Diagnostic Classification of Patients With Temporomandibular Disorders: Implications for Physical Therapists

Management of rhinosinusitis in Dutch general practice

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