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What Is Sinusitis?

Sinusitis is defined as an inflammatory process involving the mucous membranes of the paranasal (para = near + nasal = nose) sinuses (sinus = space or cavity). 

As it is difficult to differentiate rhinitis alone from sinusitis, or visa versa, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Task Force on Rhinosinusitis recommends a grouping of these diagnosis into one term, rhinosinusitis (Anon,1995). In common practice, sinusitis is used to describe this process. 

Sinusitis is the most common chronic disease in America. Approximately, 30 million Americans are affected by this disease and much like asthma, the number of effected individuals is rising. Clinically, this is an inflammatory process of the mucous membranes and sinuses. Effected individuals most often complain of a combination of facial pain and infected nasal drainage.  Despite the frequency of sinusitis, until recently little consensus has existed as to the precise description of sinusitis. 

Without an accepted description of the clinical course of sinusitis, the ability to develop and communicate treatment strategies was at best difficult. For example, little agreement existed for differentiating acute from chronic sinusitis. The United States Food and Drug Administration (FDA) had used at the time of the AAO-HNS Task Force a period of 4 weeks to separate acute from chronic infections, and in the prior decade, FDA studies had been performed using only 2 weeks to separate one process from the other (Lanza, 1997; Schaefer, 1985). 

Another definitional problem was reconciling the temporal nomenclature for another similar respiratory tract infectious process, otitis media, with that of rhinosinusitis which lacks a "subacute" clinical description (Goycoolea, 1991). The AAO-HNS Task Force resolved these issues by defining acute sinusitis as less than 4 weeks in duration, subacute sinusitis as 4 to 12 weeks and chronic as greater than 12 weeks (Anon, 1997; Lanza, 1997). 

References

Anon, J.B. 1997 Report of the rhinosinusitis task force committee meeting. Otolaryngol. Head Neck Surg. Suppl., 117:S1-68.

Goycoolea, M.V., Hueb, M.M., and Ruab, C. 1991 Otitis media: The pathogenesis approach. Definitions and terminology. Otolaryngol. Clin. North Am., 24:757-761.

Lanza, D.C. and Kennedy, D.W. 1997 Adult rhinosinusitis defined. Otolaryngol. Head Neck Surg. Suppl., 117:S1-7.

Schaefer, S.D. and Ronis, M.L. 1985 Cephalexin in the treatment of acute and chronic maxillary sinusitis. South. Med. J., 78:45-47.

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