xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

236

International consensus statement on rhinosinusitis

VII. Acute Rhinosinusitis (ARS) .......................................................................................................... 272 VII.A. Incidence and Prevalence of ARS .......................................................................................... 272 VII.B. Diagnosis of ARS ................................................................................................................. 272 VII.B.1. Establishing the Diagnosis of ARS ............................................................................. 273 VII.B.2. Differentiating Viral from Bacterial ARS .................................................................... 274 VII.C. Pathophysiology of ARS ....................................................................................................... 274 VII.C.1. Contributing Factors for ARS: Anatomic Variants and Septal Deviation .......................... 274 VII.C.2. Contributing Factors for ARS: Allergy ....................................................................... 282 VII.C.3. Contributing Factors for ARS: Viruses ....................................................................... 286 VII.C.4. Contributing Factors for ARS: Odontogenic Infections ................................................ 286 VII.D. Management of ARS ............................................................................................................ 291 VII.D.1. ARS Management: Antibiotics .................................................................................. 291 VII.D.2. ARS Management: Corticosteroids ............................................................................ 293 VII.D.2.a. ARS Management: Intranasal Corticosteroids (INCS) ...................................... 293 VII.D.2.b. ARS Management: Systemic Corticosteroids .................................................. 296 VII.D.3. ARS Management: Topical Saline Spray and Irrigation ................................................ 296 VII.D.4. ARS Management: Decongestants and Other Adjunctive Treatments ............................ 297 VII.D.4.a. Decongestants ........................................................................................... 297 VII.D.4.b. Antihistamines .......................................................................................... 297 VII.D.4.c. Mucolytics ................................................................................................ 302 VII.D.4.d. Herbal Remedies ....................................................................................... 305 VII.E. Complications of ARS .......................................................................................................... 305 VIII. Recurrent Acute Rhinosinusitis (RARS) ..................................................................................... 307 VIII.A. Incidence and Prevalence of RARS ....................................................................................... 307 VIII.B. Diagnosis of RARS ............................................................................................................. 307 VIII.B.1. Establishing the Diagnosis of RARS ......................................................................... 308 VIII.B.2. Differential Diagnosis of RARS ................................................................................ 309 VIII.C. Pathophysiology of RARS .................................................................................................... 310 VIII.C.1. Contributing Factors for RARS: Allergy, Immunologic Defects, and Resistant Bacteria .... 310 VIII.C.2. Contributing Factors for RARS: Anatomic Factors ...................................................... 311 VIII.D. Management of RARS ......................................................................................................... 311 VIII.D.1. RARS Management: Intranasal Corticosteroids (INCS) ............................................... 311 VIII.D.2. RARS Management: Antibiotics ............................................................................... 315 VIII.D.3. RARS Management: Endoscopic Sinus Surgery .......................................................... 315 IX. Chronic Rhinosinusitis without Nasal Polyps (CRSsNP) ................................................................ 316 IX.A. Incidence and Prevalence of CRSsNP ...................................................................................... 316 IX.B. Diagnosis of CRSsNP ............................................................................................................. 317 IX.B.1. Establishing the Diagnosis of CRS ............................................................................... 317 IX.B.2. Differential Diagnosis of CRSsNP ............................................................................... 318 IX.B.3. Cost Effective Work Up of CRS ................................................................................... 318 IX.B.3.a. CRS Diagnosis Using “Symptoms Alone” ........................................................ 323 IX.B.3.b. CRS Diagnosis with Nasal Endoscopy ............................................................. 323 IX.B.3.c. CRS Workup with Diagnostic Imaging ............................................................ 324 IX.C. Pathophysiology of CRSsNP ................................................................................................... 325 IX C.1. Contributing Factors for CRSsNP: Allergy ................................................................... 325 IX.C.2. Contributing Factors for CRSsNP: Biofilms ................................................................. 326 IX.C.3. Contributing Factors for CRS: Fungus ........................................................................ 332 IX.C.4. Contributing Factors for CRS: Neo-osteogenesis .......................................................... 334 IX.C.5. Contributing Factors for CRS: Gastroesophageal Reflux ................................................ 338