Linked Life Data

19879446

Source:http://linkedlifedata.com/resource/pubmed/id/19879446

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2009-11-2
pubmed:abstractText
This article examines the modalities in the treatment of chronic rhinosinusitis (CRS). A correct diagnosis is the first requirement in the successful management of CRS. CRS-directed therapy might fail if the actual cause of symptoms is nonsinogenic. Nasal endoscopy and sinus computed tomography are the primary modalities used in the diagnosis of sinusitis. Allergy and gastroesophageal reflux, may not directly cause sinusitis, but they frequently mimic the symptoms of sinusitis. Therapy can include avoidance of allergens and desensitization in the former and antireflux therapy in the latter. Underlying systemic causes of refractory sinusitis include immunodeficiency and systemic granulomatous and eosinophilic syndromes. Correct diagnosis is essential to directed therapy. Patients with aspirin exacerbated respiratory disease may benefit from aspirin desensitization. Optimization of mucociliary clearance can be augmented with nasal lavage and mucolytics. Additional nonsteroidal antiinflammatory modalities include use of the leukotriene modulators, montelukast and zileuton. Patients with elevated IgE may benefit from omalizumab (anti-IgE); however, cost constraints restrict use to those patients who have severe asthma. This article also includes management strategies beyond the usual antibiotics, steroids, and sinus surgery. Once immunodeficiency and confounding local mimics of sinusitis are addressed, additional interventions should be tried separately initially to assess the individual patient's response to therapy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1557-8607
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
29
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
719-32
pubmed:meshHeading
pubmed:year
2009
pubmed:articleTitle
When surgery, antibiotics, and steroids fail to resolve chronic rhinosinusitis.
pubmed:affiliation
Division of Sinonasal Disorders and Allergy, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Mercy, 1400 Locust Street, Suite B11500, Pittsburgh, PA 15219, USA. fergusonbj@upmc.edu
pubmed:publicationType
Journal Article, Review