Thaler / Kennedy Rhinosinusitis

A Guide for Diagnosis and Management
1. Auflage 2009
ISBN: 978-0-387-73062-2
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 281 Seiten

Rhinosinusitis is one of the most common health care complaints, with many millions of cases managed annually by a variety of practitioners, from family care physicians and pediatricians to allergists, pulmonologists, and otolaryngologists. Rhinosinusitis: A Guide for Diagnosis and Management provides a comprehensive, practical guide to treating this widespread condition. Medical, surgical, and pharmacological management of both acute and chronic forms are discussed by experts with a wealth of clinical experience. Pediatric considerations and the role of allergies, asthma, and systemic diseases such as cystic fibrosis are discussed. A special chapter is devoted to alternative medicine in recognition of its increasing role in health care management. Diagnostic imaging techniques such as MRI and CT are discussed in detail. Finally, adjunctive surgical therapies are reviewed. Written for both primary care physicians and specialists, this guide will serve as an invaluable quick reference.

Autoren/Hrsg.

Thaler, Erica

Kennedy, David W.

Inhaltsverzeichnis

1;Preface;6
2;Contents;7
3;Contributors;9
4;to 1 Etiology and Impact of Rhinosinusitis;12
4.1; Definition of Rhinosinusitis;12
4.2; Epidemiology of Rhinosinusitis;15
4.3; Etiology of Rhinosinusitis;15
4.3.1; Environmental Factors;15
4.3.1.1; Microbial Pathogens in Rhinosinusitis;15
4.3.1.2; Allergy;17
4.3.1.3; Asthma;18
4.3.1.4; Pollution;19
4.3.2; Anatomic Factors;19
4.3.2.1; Mucociliary Impairment;19
4.3.2.2; Anatomic Variations;19
4.3.3; Systemic Disorders and Rhinosinusitis;20
4.3.3.1; Immunodeficiency;20
4.3.3.2; Genetic Disorders;21
4.3.3.3; Laryngopharyngeal Reflux;21
4.3.3.4; Endocrine State;21
4.4; Economic Impact of Rhinosinusitis;22
4.5; Quality-of-Life Impact of Rhinosinusitis;23
5;to 2 Microbiology and Immunology of Rhinosinusitis;27
5.1; Microbiology;28
5.1.1; Viral Rhinosinusitis;28
5.1.2; Acute Bacterial Rhinosinusitis;28
5.1.3; Subacute Rhinosinusitis;30
5.1.4; Chronic Rhinosinusitis;30
5.1.5; Recurrent, Acute Rhinosinusitis;31
5.1.6; Acute Exacerbation of Chronic Rhinosinusitis;31
5.1.7; Fungal Rhinosinusitis;32
5.2; Immunology;34
5.2.1; Innate Immunity;35
5.2.2; Adaptive Immunity;35
5.3; Summary;36
6;to 3 Diagnosis and Management of Acute Rhinosinusitis;39
6.1; Definition;39
6.2; Pathophysiology;40
6.3; Epidemiology;41
6.4; Presenting Symptoms and Signs;41
6.4.1; Fever, Nasal Obstruction, Pain, Headache, Purulent Rhinorrhea;41
6.4.2; Associated Factors;42
6.4.3; Sinonasal Endoscopy;42
6.4.4; Sinonasal Culture;43
6.4.5; Laboratory Data;43
6.4.6; Imaging;44
6.4.6.1; Ultrasound;44
6.4.6.2; X-Ray;44
6.4.6.3; Computed Tomography;44
6.5; Diagnosis of Complicated Acute Rhinosinusitis;47
6.6; Controversy;47
7;to 4 Diagnosis of Chronic Rhinosinusitis;50
7.1; Defining CRS;50
7.1.1; Rhinitis Versus Rhinosinusitis;51
7.1.2; CRS as a Multifactorial Disease;51
7.1.3; The Sinonasal Symptoms;52
7.1.3.1; Local Symptoms;52
7.1.3.2; Regional and Systemic Symptoms;53
7.1.3.3; Duration of Symptoms;53
7.1.4; CRS with Polyps;53
7.1.5; Current Concepts;54
7.2; Presenting Symptoms and Differential Diagnoses;56
7.2.1; Nasal Obstruction/Congestion/Blockage/Stuffiness;56
7.2.1.1; Clinical Basis;56
7.2.1.2; Differential Diagnoses for Nasal Obstruction;57
7.2.1.3; Objective Evaluation of Nasal Obstruction;57
7.2.2; Nasal Discharge and Postnasal Drip;59
7.2.2.1; Clinical Basis;59
7.2.2.2; Differential Diagnoses for Nasal Discharge;59
7.2.2.3; Objective Evaluation;60
7.2.3; Facial Pain, Ache, Headache, and Pressure;60
7.2.3.1; Clinical Basis;60
7.2.3.2; Differential Diagnoses for "Sinus" Pain;60
7.2.3.3; Objective Evaluation of Pain;60
7.2.4; Reduction or Loss (Anosmia) of Smell;61
7.2.4.1; Clinical Basis;61
7.2.4.2; Differential Diagnoses for Loss of Smell;61
7.2.4.3; Objective Evaluation of Smell (Olfaction);61
7.3; Regional Symptoms;61
7.3.1; Cough;61
7.3.1.1; Clinical Basis;61
7.3.1.2; Differential Diagnoses for Cough;62
7.3.1.3; Objective Evaluation of Cough;62
7.3.2; Halitosis;62
7.3.2.1; Clinical Basis;62
7.3.2.2; Differential Diagnoses for Halitosis;62
7.3.2.3; Objective Evaluation of Halitosis;62
7.3.3; Warnings and Pitfalls;63
7.4; Other Significant Patient History;64
7.4.1; Medications;64
7.4.2; Past Medical History;64
7.4.3; Social History;64
7.4.4; Family History;64
7.5; Primary and Secondary Investigations;65
7.5.1; Endoscopy;65
7.5.2; Anterior Rhinoscopy;67
7.5.3; CT Scan;67
7.5.4; X-Ray;68
7.5.5; Secondary Investigations;69
7.6; Diagnostic Schemes;69
7.6.1; Adult CRS;70
7.6.2; Pediatric CRS;70
8;to 5 Medical Management of Acute Rhinosinusitis;74
8.1; Treatment Strategy;74
8.1.1; Antiinflammatory Therapy;75
8.1.2; Decongestant Therapy;76
8.1.3; Antihistamine Therapy;77
8.1.4; Anticholinergic Therapy;77
8.1.5; Mucous Transport Therapies;78
8.1.6; Antimicrobial Therapy;78
8.2; Conclusion;81
9;to 6 Medical Management of Chronic Rhinosinusitis;84
9.1; Microbiology and Antibiotic Selection;85
9.1.1; Selection of Routine Antibiotic Therapy;85
9.1.2; Unique Roles of Bacteria in CRS;87
9.1.3; Novel Antibiotic Delivery Methods;88
9.2; Role of Fungi and Antifungal Therapy;89
9.3; Immunomodulatory Therapies;90
9.3.1; Intranasal Corticosteroids;90
9.3.2; Systemic Steroids;93
9.3.3; Allergy Management;95
9.3.4; Other Immunomodulatory Considerations;96
9.3.4.1; Aspirin Desensitization;96
9.3.4.2; Macrolide Therapy;97
9.4; Summary and Conclusions;97
10;to 7 Endoscopic Sinus Surgery;101
10.1; The Role of Underlying Pathogenesis in Patient Selection for Surgery;104
10.2; The Role of Patient Symptoms in Selection for Surgery;104
10.3; The Role of Imaging and Endoscopy in Patient Selection for Surgery;105
10.4; Selecting Patients for Surgery;106
10.5; Selecting the Surgeon for Your Patients;108
10.6; Patient Preparation for Surgical Intervention;108
10.7; The Surgical Procedure;109
10.8; Postoperative Management;111
10.9; Complications of Surgery;112
10.10; Summary;113
11;to 8 Allergy and Rhinosinusitis;115
11.1; Epidemiology and Burden of Nasal Allergy;115
11.2; Pathophysiology of Allergy;116
11.3; Allergic Rhinitis: Overview;119
11.4; Diagnosis of Allergic Rhinitis;120
11.4.1; History;120
11.4.2; Physical Examination;121
11.4.3; Allergy Testing;122
11.4.3.1; Screening Tests;122
11.4.3.2; Confirmatory Tests;123
11.5; The Association of Allergy and Rhinosinusitis;126
11.6; Treatment of Allergic Rhinitis in the Patient with Rhinosinusitis;128
11.6.1; Avoidance;128
11.6.2; Pharmacotherapy;129
11.6.2.1; Antihistamines;130
11.6.2.2; Decongestants;131
11.6.2.3; Corticosteroids;132
11.6.2.4; Leukotriene Modifiers;134
11.6.3; Immunotherapy;134
11.7; Framework for Managing Concurrent Allergic Rhinitis and Rhinosinusitis;135
11.8; Conclusion;137
12;to 9 Complementary and Alternative Medicine in Rhinology;140
12.1; Herbal Medicines;141
12.2; Acupuncture;144
12.3; Homeopathy;144
12.4; Other Complementary and Alternative Therapies;146
12.4.1; Vitamin C;146
12.4.2; Urtica dioca;146
12.4.3; Nasal Irrigation;146
12.4.4; Humming;147
12.4.5; Phototherapy;147
12.5; Conclusions;147
13;to 10 Radiology: Its Diagnostic Usefulness in Rhinosinusitis;151
13.1; Development;151
13.2; Anatomy;151
13.3; Imaging Sinonasal Disease: The Radiologist's Arsenal;154
13.3.1; Plain Film Radiographs;154
13.3.2; Computed Tomography;154
13.3.3; Magnetic Resonance Imaging;155
13.4; Imaging Disease Processes of the Paranasal Sinuses;156
13.4.1; Inflammatory Disease/Rhinosinusitis;156
13.4.2; Congenital Lesions;162
13.4.3; Neoplasms;162
13.4.3.1; Papillomas;165
13.4.3.2; Malignant Neoplasms;165
13.5; Summary;168
14;to 11 Systemic Diseases and Chronic Rhinosinusitis;170
14.1; Autoimmune Disorders;170
14.1.1; Wegener's Granulomatosis;170
14.1.2; Sarcoidosis;172
14.1.3; Cystic Fibrosis;173
14.1.4; Churg--Strauss Syndrome;174
14.1.5; Relapsing Polychondritis;175
14.1.6; Lupus;176
14.2; Infectious Processes;177
14.2.1; Fungal Infections;177
14.2.2; Syphilis;179
14.2.3; Mycobacterium;180
14.2.4; Rhinoscleroma;181
14.3; Hematologic-Oncologic Illnesses;182
14.3.1; Neoplasms;182
14.3.2; Hereditary Hemorrhagic Telangiectasia;184
14.3.3; Human Immunodeficiency Virus (HIV);186
14.3.4; Substance Abuse: Cocaine;187
14.4; Conclusion;188
15;to 12 Reactive Airway Disease and the Management of Samter0s Triad;191
15.1; Reactive Airway Disease and the Unified Airway;192
15.1.1; Temporal Association;192
15.1.2; Physiological Relationship;192
15.1.3; Histopathology;193
15.1.4; Therapeutic Association;193
15.2; Aspirin-Exacerbated Respiratory Disease (Samter's Triad);194
15.2.1; Epidemiology;194
15.2.2; Pathophysiology;195
15.2.3; Assessment and Diagnosis;197
15.3; Management of Samter's Triad;198
15.3.1; Medical Therapy;198
15.3.2; Aspirin Desensitization;200
15.3.3; Surgical Management;201
15.4; Conclusions;204
16;to 13 Pediatric Perspectives of Rhinosinusitis;208
16.1; Embryology And Anatomic Considerations;208
16.2; Physiology;209
16.3; Definitions;210
16.4; Prevalence;210
16.5; Differential Diagnosis of Rhinosinusitis;211
16.6; Risks of ARS and CRS;211
16.7; Diagnostic Tests;212
16.7.1; Diagnosis Bacterial ARS;212
16.7.2; Clinical Examination;213
16.7.3; Imaging Studies;213
16.8; Diagnosis of Chronic/Recurrent RS;215
16.8.1; Microbiology;215
16.9; Rationale for Treatment of ARS;216
16.10; Treatment Strategies;216
16.10.1; Antibiotic Therapy for ARS/Recurrent ARS;216
16.10.2; Antibiotics for CRS/Treatment Failure;218
16.10.3; Surgical Therapy;219
16.10.4; Special Considerations in Managing RS in Children;219
16.11; Complications;220
16.11.1; Local Complications;220
16.11.2; Systemic Complications;221
16.12; Summary;223
17;to 14 Spectrum of Fungal Sinusitis;226
17.1; Noninvasive Fungal Sinusitis;226
17.1.1; Characteristics of Fungus;226
17.1.2; Fungal Balls;228
17.1.2.1; Diagnosis;228
17.1.2.2; Treatment;228
17.1.2.3; Allergic Fungal Sinusitis;228
17.1.2.4; Diagnosis;229
17.1.2.5; Therapy;231
17.2; Invasive Fungal Sinusitis;233
17.2.1; Characteristics of Fungus;233
17.2.2; Acute Invasive Fungal Sinusitis;233
17.2.2.1; Diagnosis;234
17.2.2.2; Treatment;235
17.2.3; Chronic Invasive Fungal Sinusitis;238
17.2.3.1; Diagnosis;238
17.2.3.2; Treatment;238
17.3; Conclusion;239
18;to 15 Complications of Rhinosinusitis;242
18.1; Anatomy;242
18.2; Orbital Complications;244
18.2.1; Intracranial Complications;247
18.2.2; Bony Complications;249
18.3; Conclusion;251
19;to 16 Adjunctive Surgical Therapies in the Treatment of Rhinosinusitis;253
19.1; Anatomy and Physiology;254
19.2; Adjunctive Surgical Therapies;254
19.2.1; Preoperative Considerations;254
19.3; Surgical Procedures;256
19.3.1; Surgery of the External Nose and Nasal Septum;256
19.3.2; Surgery of the Inferior Turbinate;257
19.3.3; Ultraviolet Phototheraphy;259
19.3.4; Balloon Sinuplasty;260
19.3.5; Office Treatment of Sinonasal Polyps;261
19.3.6; Adenoidectomy;262
19.3.7; Vidian Neurectomy;263
19.4; Conclusion;264
20;Index;267