Editing Sinusitis (section)

{{cs1 config|name-list-style=vanc|display-authors=6}}{{Infobox medical condition (new)
| name = Rhinosinusitis
| synonyms = Sinus infection, sinusitis, chronic rhinosinusitis without nasal polyps, chronic rhinosinusitis with nasal polyps
| image = Sinusitis cdc.png
| caption = An illustration showing the difference between healthy sinuses and diseased sinuses
| image2 = 
| field = [[Otorhinolaryngology]]
| symptoms = [[nasal discharge]], [[nasal blockage]], [[facial pain]], reduction or loss of smell, [[fever]]<ref name="pmid25833927"/><ref name="pmid27113482"/>
| onset = 
| duration = 
| causes = [[Infection]] (bacterial, fungal, viral), [[allergy|allergies]], [[air pollution]], structural problems in the nose<ref name="cdc.gov-20132" />
| risks = [[Asthma]], [[cystic fibrosis]], [[immunodeficiency|poor immune function]]<ref name="pmid25833927"/>
| diagnosis = Usually based on symptoms
| differential = [[common cold]], [[rhinitis]], [[upper respiratory infection]], [[temporomandibular joint disorder]], [[tension headache]], [[vascular headache]], [[dental infection]]
| prevention = handwashing, vaccinations, avoiding smoking<ref name="cdc.gov-20132" />
| treatment = [[Analgesics|Pain medications]], [[nasal steroid]]s, [[nasal irrigation]], [[antibiotic]]<ref name="pmid25833927"/><ref name="pmid25892369"/>
| medication = 
| prognosis = 
| frequency = 10–30% each year (developed world)<ref name="pmid25833927"/><ref name="Adkinson-2014"/>
| deaths = 
| complications = 
}}<!-- Definition and symptoms -->
'''Sinusitis''', also known as '''rhinosinusitis''', is an [[inflammation]] of the [[Nasal mucosa|mucous membranes]] that line the [[Paranasal sinuses|sinuses]] resulting in symptoms that may include production of thick [[Mucus#Respiratory system|nasal mucus]], [[nasal congestion]], facial congestion, [[Orofacial pain|facial pain]], facial pressure, [[Hyposmia|loss of smell]], or [[fever]].<ref name="pmid258339273">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |date=April 2015 |title=Clinical practice guideline (update): Adult Sinusitis Executive Summary |journal=Otolaryngology–Head and Neck Surgery |volume=152 |issue=4 |pages=598–609 |doi=10.1177/0194599815574247 |pmid=25833927 |s2cid=206469424 |doi-access=free}}</ref>'''<ref>{{cite journal |vauthors=Head K, Chong LY, Piromchai P, Hopkins C, Philpott C, Schilder AG, Burton MJ |date=April 2016 |title=Systemic and topical antibiotics for chronic rhinosinusitis |url=http://discovery.ucl.ac.uk/1489913/1/Schilder_Head_et_al-2016-The_Cochrane_library.pdf |url-status=live |journal=The Cochrane Database of Systematic Reviews |volume=2016 |issue=4 |pages=CD011994 |doi=10.1002/14651858.CD011994.pub2 |pmc=8763400 |pmid=27113482 |s2cid=205210696 |archive-url=https://web.archive.org/web/20180722030626/http://discovery.ucl.ac.uk/1489913/1/Schilder_Head_et_al-2016-The_Cochrane_library.pdf |archive-date=2018-07-22 |access-date=2019-09-17}}</ref>'''

<!-- Cause and diagnosis -->
Sinusitis is a condition that affects both children and adults. It is caused by a combination of environmental and a person's individual health factors.<ref>{{Citation |last1=Battisti |first1=Amanda S. |title=Sinusitis |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK470383/ |access-date=2024-11-12 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29262090 |last2=Modi |first2=Pranav |last3=Pangia |first3=Jon |archive-date=2023-11-18 |archive-url=https://web.archive.org/web/20231118134212/http://www.ncbi.nlm.nih.gov/books/NBK470383/ |url-status=live }}</ref> It can occur in individuals with [[Allergy|allergies]], exposure to environmental irritants, structural abnormalities of the [[nasal cavity]] and [[Paranasal sinuses|sinuses]] and [[Immunodeficiency|poor immune function]].<ref name="Adkinson-20143">{{cite book |last1=Adkinson |first1=N. Franklin |url=https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |title=Middleton's allergy: principles and practice |date=2014 |publisher=Elsevier Saunders |isbn=9780323085939 |edition=Eight |location=Philadelphia |page=687 |archive-url=https://web.archive.org/web/20160603211855/https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |archive-date=2016-06-03 |url-status=live}}</ref> Most cases are caused by a [[viral infection]].<ref name="cdc.gov-20132">{{cite web |date=September 30, 2013 |title=Sinus Infection (Sinusitis) |url=https://www.cdc.gov/getsmart/antibiotic-use/URI/sinus-infection.html |url-status=live |archive-url=https://web.archive.org/web/20150407181505/http://www.cdc.gov/getsmart/antibiotic-use/URI/sinus-infection.html |archive-date=7 April 2015 |access-date=6 April 2015 |website=cdc.gov}}</ref> Recurrent episodes are more likely in persons with [[asthma]], [[cystic fibrosis]], and [[immunodeficiency]].<ref name="pmid258339275">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |date=April 2015 |title=Clinical practice guideline (update): Adult Sinusitis Executive Summary |journal=Otolaryngology–Head and Neck Surgery |volume=152 |issue=4 |pages=598–609 |doi=10.1177/0194599815574247 |pmid=25833927 |s2cid=206469424 |doi-access=free}}</ref>

The diagnosis of sinusitis is based on the symptoms and their duration along with signs of disease identified by [[Endoscopy|endoscopic]] and/or [[Radiology|radiologic]] criteria.<ref name="Adkinson-20142">{{cite book |last1=Adkinson |first1=N. Franklin |url=https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |title=Middleton's allergy: principles and practice |date=2014 |publisher=Elsevier Saunders |isbn=9780323085939 |edition=Eight |location=Philadelphia |page=687 |archive-url=https://web.archive.org/web/20160603211855/https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |archive-date=2016-06-03 |url-status=live}}</ref> Sinusitis is classified into acute sinusitis, subacute sinusitis and chronic sinusitis. In acute sinusitis, symptoms last for less than 4 weeks, and in subacute sinusitis they last between 4 and 12 weeks. In chronic sinusitis symptoms must be present for at least 12 weeks.<ref>{{Cite book |title=Middleton's allergy: principles and practice |date=2014 |publisher=Elsevier/Saunders |isbn=978-0-323-08593-9 |editor-last=Adkinson |editor-first=N. Franklin |edition=8th |location=Philadelphia, PA |editor-last2=Middleton |editor-first2=Elliott}}</ref> In the initial evaluation of sinusitis an [[otolaryngologist]], also known as an [[Ear, Nose and Throat|ear, nose and throat]] (ENT) doctor, may confirm sinusitis using  [[Endoscopy|nasal endoscopy]].<ref name="Adkinson-20142" /> Diagnostic imaging is not usually needed in acute stage unless complications are suspected.<ref name="pmid258339274">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |date=April 2015 |title=Clinical practice guideline (update): Adult Sinusitis Executive Summary |journal=Otolaryngology–Head and Neck Surgery |volume=152 |issue=4 |pages=598–609 |doi=10.1177/0194599815574247 |pmid=25833927 |s2cid=206469424 |doi-access=free}}</ref> In chronic cases, confirmatory testing is recommended by use of [[computed tomography]].<ref name="pmid258339274" />

<!-- Prevention and treatment -->
Prevention of sinusitis focuses on regular hand washing, staying up-to date on [[Vaccination|vaccinations]], and avoiding [[smoking]].<ref name="cdc.gov-20133">{{cite web |date=September 30, 2013 |title=Sinus Infection (Sinusitis) |url=https://www.cdc.gov/getsmart/antibiotic-use/URI/sinus-infection.html |url-status=live |archive-url=https://web.archive.org/web/20150407181505/http://www.cdc.gov/getsmart/antibiotic-use/URI/sinus-infection.html |archive-date=7 April 2015 |access-date=6 April 2015 |website=cdc.gov}}</ref> [[Analgesics|Pain killers]] such as [[naproxen]], [[Nasal steroid|nasal steroids]], and [[nasal irrigation]] may be used to help with symptoms.<ref name="pmid258339276">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |date=April 2015 |title=Clinical practice guideline (update): Adult Sinusitis Executive Summary |journal=Otolaryngology–Head and Neck Surgery |volume=152 |issue=4 |pages=598–609 |doi=10.1177/0194599815574247 |pmid=25833927 |s2cid=206469424 |doi-access=free}}</ref><ref name="pmid258923692">{{cite journal |vauthors=King D, Mitchell B, Williams CP, Spurling GK |date=April 2015 |title=Saline nasal irrigation for acute upper respiratory tract infections |url=http://espace.library.uq.edu.au/view/UQ:201653/UQ201653_OA.pdf |url-status=live |journal=The Cochrane Database of Systematic Reviews |volume=2015 |issue=4 |pages=CD006821 |doi=10.1002/14651858.CD006821.pub3 |pmc=9475221 |pmid=25892369 |archive-url=https://web.archive.org/web/20210829061619/https://espace.library.uq.edu.au/data/UQ_201653/UQ201653_OA.pdf?Expires=1630217866&Key-Pair-Id=APKAJKNBJ4MJBJNC6NLQ&Signature=fvzZFSRIkQZTLEhLp~QFYol~hVWVs5Yo2o0Vw3BhGOL7U3pmZx7K1xwMdix20C-ZBOBTDrFZyWfczpiMKk7xmMWYUsYU8tEF9SRghcv~x04vWlZkkUuL3E7OHRYrkCFawyesJkkEEQO5sQxtD0LLWuoQWlT7yRRWk4ZqrLeW7OCsFY5NhBYavteJhqCqtWifH5hIamsdfCYNZnVKx4mp66bQ5L5iozTDtmriPethrPxdoRvyPvYoPscI~ayOcvCjCjdYxsooSxLtw1KPpsbBbtEACOPp35YxrEPcON9XJO04wJeqpcy9FsRhJHM1Gg1-b8p5xUSx3LRrF42Dirskaw__ |archive-date=2021-08-29 |access-date=2018-04-20}}</ref> Recommended initial treatment for acute sinusitis is [[watchful waiting]].<ref name="pmid258339276" /> If symptoms do not improve in 7–10 days or worsen, then an [[antibiotic]] may be implemented or changed.<ref name="pmid258339276" /> In those in whom antibiotics are indicated, either [[amoxicillin]] or [[amoxicillin/clavulanate]] is recommended first line, with [[amoxicillin/clavulanate]] being superior to [[amoxicillin]] alone but with more side effects.<ref name="pmid332365252">{{cite journal |last1=Orlandi |first1=Richard R. |last2=Kingdom |first2=Todd T. |last3=Smith |first3=Timothy L. |last4=Bleier |first4=Benjamin |last5=DeConde |first5=Adam |last6=Luong |first6=Amber U. |last7=Poetker |first7=David M. |last8=Soler |first8=Zachary |last9=Welch |first9=Kevin C. |last10=Wise |first10=Sarah K. |last11=Adappa |first11=Nithin |last12=Alt |first12=Jeremiah A. |last13=Anselmo-Lima |first13=Wilma Terezinha |last14=Bachert |first14=Claus |last15=Baroody |first15=Fuad M. |year=2021 |title=International consensus statement on allergy and rhinology: rhinosinusitis 2021 |url=https://ueaeprints.uea.ac.uk/id/eprint/77501/1/Accepted_Manuscript.pdf |url-status=live |journal=International Forum of Allergy & Rhinology |publisher=Wiley |volume=11 |issue=3 |pages=213–739 |doi=10.1002/alr.22741 |issn=2042-6976 |pmid=33236525 |s2cid=227165628 |archive-url=https://web.archive.org/web/20230307191717/https://ueaeprints.uea.ac.uk/id/eprint/77501/1/Accepted_Manuscript.pdf |archive-date=2023-03-07 |access-date=2023-01-21 |last16=Batra |first16=Pete S. |last17=Bernal-Sprekelsen |first17=Manuel |last18=Beswick |first18=Daniel |last19=Bhattacharyya |first19=Neil |last20=Chandra |first20=Rakesh K. |last21=Chang |first21=Eugene H. |last22=Chiu |first22=Alexander |last23=Chowdhury |first23=Naweed |last24=Citardi |first24=Martin J. |last25=Cohen |first25=Noam A. |last26=Conley |first26=David B. |last27=DelGaudio |first27=John |last28=Desrosiers |first28=Martin |last29=Douglas |first29=Richard |last30=Eloy |first30=Jean Anderson |last31=Fokkens |first31=Wytske J. |last32=Gray |first32=Stacey T. |last33=Gudis |first33=David A. |last34=Hamilos |first34=Daniel L. |last35=Han |first35=Joseph K. |last36=Harvey |first36=Richard |last37=Hellings |first37=Peter |last38=Holbrook |first38=Eric H. |last39=Hopkins |first39=Claire |last40=Hwang |first40=Peter |last41=Javer |first41=Amin R. |last42=Jiang |first42=Rong-San |last43=Kennedy |first43=David |last44=Kern |first44=Robert |last45=Laidlaw |first45=Tanya |last46=Lal |first46=Devyani |last47=Lane |first47=Andrew |last48=Lee |first48=Heung-Man |last49=Lee |first49=Jivianne T. |last50=Levy |first50=Joshua M. |last51=Lin |first51=Sandra Y. |last52=Lund |first52=Valerie |last53=McMains |first53=Kevin C. |last54=Metson |first54=Ralph |last55=Mullol |first55=Joaquim |last56=Naclerio |first56=Robert |last57=Oakley |first57=Gretchen |last58=Otori |first58=Nobuyoshi |last59=Palmer |first59=James N. |last60=Parikh |first60=Sanjay R. |last61=Passali |first61=Desiderio |last62=Patel |first62=Zara |last63=Peters |first63=Anju |last64=Philpott |first64=Carl |last65=Psaltis |first65=Alkis J. |last66=Ramakrishnan |first66=Vijay R. |last67=Ramanathan |first67=Murugappan |last68=Roh |first68=Hwan-Jung |last69=Rudmik |first69=Luke |last70=Sacks |first70=Raymond |last71=Schlosser |first71=Rodney J. |last72=Sedaghat |first72=Ahmad R. |last73=Senior |first73=Brent A. |last74=Sindwani |first74=Raj |last75=Smith |first75=Kristine |last76=Snidvongs |first76=Kornkiat |last77=Stewart |first77=Michael |last78=Suh |first78=Jeffrey D. |last79=Tan |first79=Bruce K. |last80=Turner |first80=Justin H. |last81=Drunen |first81=Cornelis M. |last82=Voegels |first82=Richard |last83=Wang |first83=De Yun |last84=Woodworth |first84=Bradford A. |last85=Wormald |first85=Peter-John |last86=Wright |first86=Erin D. |last87=Yan |first87=Carol |last88=Zhang |first88=Luo |last89=Zhou |first89=Bing}}</ref><ref name="pmid258339276" /> Surgery may be recommended in those with chronic disease who have failed medical management.<ref>{{cite web |date=April 3, 2012 |title=How Is Sinusitis Treated |url=https://www.niaid.nih.gov/topics/sinusitis/Pages/treatment.aspx |url-status=live |archive-url=https://web.archive.org/web/20150405025201/http://www.niaid.nih.gov/topics/sinusitis/Pages/treatment.aspx |archive-date=5 April 2015 |access-date=6 April 2015}}</ref>

<!-- Epidemiology and society -->
Sinusitis is a common condition.<ref name="pmid258339272">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |date=April 2015 |title=Clinical practice guideline (update): Adult Sinusitis Executive Summary |journal=Otolaryngology–Head and Neck Surgery |volume=152 |issue=4 |pages=598–609 |doi=10.1177/0194599815574247 |pmid=25833927 |s2cid=206469424 |doi-access=free}}</ref> It affects between about 10 and 30 percent of people each year in the United States and Europe.<ref name="pmid258339272" /><ref name="Adkinson-2014">{{cite book |last1=Adkinson |first1=N. Franklin |url=https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |title=Middleton's allergy: principles and practice |date=2014 |publisher=Elsevier Saunders |isbn=9780323085939 |edition=Eight |location=Philadelphia |page=687 |archive-url=https://web.archive.org/web/20160603211855/https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687 |archive-date=2016-06-03 |url-status=live}}</ref>  The management of sinusitis in the United States results in more than {{US$}}11 billion in costs.<ref name="pmid258339272" />
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