Medical Management of Acute and Chronic Sinusitis

2015 ◽  
Keyword(s):  
Medical Management ◽  
Chronic Sinusitis

Concordance of Middle Meatal Swab and Maxillary Sinus Aspirate in Acute and Chronic Sinusitis: A Meta-Analysis

2005 ◽  
Vol 19 (5) ◽  
pp. 462-470 ◽  
Author(s):  
Marc G. Dubin ◽  
Charles S. Ebert ◽  
Charles S. Coffey ◽  
Christopher T. Melroy ◽  
Robert E. Sonnenburg ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Maxillary Sinus ◽  
Medical Management ◽  
Chronic Sinusitis ◽  
Meta Analysis ◽  
Coagulase Negative Staphylococcus ◽  
Noninvasive Method ◽  
Therapeutic Challenge ◽  
Clinical Variables ◽  
High Concordance

Background The medical management of acute and chronic sinusitis is a therapeutic challenge. The use of endoscopic middle meatal cultures as a noninvasive method to determine the bacteriology of the maxillary sinus has not accurately been established. The aim of this study was to review the literature that compares cultures obtained by endoscopic middle meatal swabs with those obtained from maxillary sinus aspirates (MSAs). Methods We reviewed studies published between January 1966 and October 2003 that were identified from searches of multiple databases, bibliographies, and original articles. Studies were included for analysis if they compared the results of endoscopic middle meatal cultures to aspirate cultures. All clinical variables and test performances were independently extracted by two reviewers. Results Middle meatal culture had a per isolate accuracy of 82% (95% confidence interval, 0.64, 0.92) compared with MSA (excluding coagulase negative staphylococcus and fungal cultures). Conclusion Endoscopic middle meatal cultures have a high concordance with MSAs.

Five-Year Follow-up of the Effects of Bilateral Intranasal Sphenoethmoidectomy in Patients with Sinusitis and Asthma

1988 ◽  
Vol 2 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Ronald Mings ◽  
William H. Friedman ◽  
Patricia A. Linford ◽  
Raymond G. Slavin
Keyword(s):  
Medical Management ◽  
Chronic Sinusitis ◽  
Subjective Improvement ◽  
Follow Up Study ◽  
Aggressive Medical Management

Chronic sinusitis has been recognized to be a contributing factor to asthma in some patients. We report a 5-year follow-up study of 16 patients who had undergone bilateral sphenoethmoidectomy after not responding to aggressive medical management of underlying sinusitis. Sixty-two percent had subjective improvement of their asthma with 88% of the patients reporting a significantly reduced prednisone requirement. All patients had improvement of their nasal and sinus symptoms at 5 years. The improvement in the asthma reported at 2 years had for the most part persisted at 5 years.

Rhinitis, Sinusitis, and Their Relationships to Allergies

1992 ◽  
Vol 6 (2) ◽  
pp. 37-43 ◽  
Author(s):  
Michael S. Benninger
Keyword(s):  
Allergic Rhinitis ◽  
Surgical Therapy ◽  
Medical Management ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Allergen Exposure ◽  
Entire Group ◽  
Nasal Sinus ◽  
Allergy Testing ◽  
The Relationship

To investigate the relationship between allergic rhinitis and sinusitis, a review of all patients seen at an outpatient suburban otolaryngology clinic was performed. Three hundred ninety-three of the 1846 (21.3%) new patients seen over an 18-month period presented with nasal complaints. Ninety-two patients had documented allergy associated rhinitis. Thirty-seven patients had strong allergic histories without allergy testing. Two thirds had worsening nasal-sinus symptoms with allergen exposure; 82% of those with seasonal symptoms noted such a relationship compared with 32% of those with nonseasonal symptoms. There was 100% correlation of the onset of acute sinusitis with worsening allergies in the allergic group, although patients with chronic sinusitis and allergies noted worsening of sinusitis with allergen exposure in only 50%. Hyposmia/anosmia or asthma were good predictors of allergies in patients presenting with nasal or sinus complaints. Sixty percent of the confirmed allergic patients responded well to medical management alone. Patients with chronic sinusitis, with or without nasal polyps, tended to respond more poorly than did the entire group to medical management alone but did better with surgical therapy.

Chronic Sinusitis: Comparison of Amoxicillin Concentration in Diseased versus Normal Mucosa

1996 ◽  
Vol 10 (5) ◽  
pp. 267-270
Author(s):  
Philip D. Kooiker ◽  
James M. Chow ◽  
James A. Stankiewicz ◽  
Ashok K. Singh
Keyword(s):  
Medical Management ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Treatment Strategies ◽  
Inferior Turbinate ◽  
Normal Mucosa ◽  
Ethmoid Sinus ◽  
Current Medical ◽  
Number Of Patients ◽  
Sinus Mucosa

Despite advances in diagnostic and treatment strategies, chronic sinusitis remains both a common entity and a difficult disease to eradicate. Current medical management, which consists primarily of extended antibiotic therapy, is effective in temporarily alleviating symptoms, but is ineffective in a number of patients in eradicating the infection. One hypothesis for the failure of medical management may be due in part to inadequate penetration of antimicrobials into the diseased sinus mucosa. In order to investigate this, mucosal specimens consisting of nasal polyps and/or diseased anterior ethmoid mucosa were harvested from 19 patients with chronic sinusitis who were being treated with Augmentin® and analyzed for amoxicillin concentrations by high pressure liquid chromatography. A biopsy of normal-appearing mucosa from the inferior turbinate was obtained from the same patient and served as the control, and was analyzed for amoxicillin concentration. Nine of 14 (64%) patients who had polyps harvested had amoxicillin concentrations in the polyps less than the amoxicillin concentration in the inferior turbinate. Two of the 14 (14%) patients had amoxicillin concentrations in the polyps greater than the amoxicillin concentration in the inferior turbinate, and the remaining three patients had amoxicillin concentrations in the polyps similar to the amoxicillin concentration in the inferior turbinate, (P = 0.029). Five of the 10 (50%) patients who had diseased anterior ethmoid sinus mucosa had amoxicillin concentrations in the diseased anterior ethmoid sinus less than the amoxicillin concentration in the inferior turbinate. Two of the 10 (20%) patients had similar amoxicillin concentrations in the diseased anterior ethmoid sinus and in the inferior turbinate and three of 10 (30%) patients with diseased anterior ethmoid sinus mucosa had amoxicillin concentrations greater than the amoxicillin concentration in the inferior turbinate. (P = 0.3725). These data suggest that there is impaired penetration of amoxicillin into nasal polyps and possibly a trend toward impaired penetration of amoxicillin into diseased anterior ethmoid sinus mucosa.

Drug-Induced Movement Disorders

2015 ◽  
Vol 25 (2) ◽  
pp. 70-77
Author(s):  
Amy Lustig ◽  
Cesar Ruiz
Keyword(s):  
Movement Disorders ◽  
Medical Management ◽  
Disease Process ◽  
Underlying Disease ◽  
Extrapyramidal Symptoms ◽  
Drug Induced ◽  
General Overview ◽  
Management Approaches ◽  
Broad Understanding ◽  
Underlying Disease Process

The purpose of this article is to present a general overview of the features of drug-induced movement disorders (DIMDs) comprised by Parkinsonism and extrapyramidal symptoms. Speech-language pathologists (SLPs) who work with patients presenting with these issues must have a broad understanding of the underlying disease process. This article will provide a brief introduction to the neuropathophysiology of DIMDs, a discussion of the associated symptomatology, the pharmacology implicated in causing DIMDs, and the medical management approaches currently in use.

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