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Kathleen Dass, Anju Tripathi Peters
Department of Allergy and Immunology, Northwestern University Feinberg School of Medicine, 211 E. Ontario Street, Ste. 1000, Chicago, IL, 60611, USA.
Curr Allergy Asthma Rep. 2016 Apr;16(4):29. doi: 10.1007/s11882-016-0607-8.
Rhinosinusitis is a commonly diagnosed disease in the USA. Rhinosinusitis is classified as acute, recurrent, or chronic (with or without nasal polyps). While acute rhinosinusitis is diagnosed by history and physical examination, chronic rhinosinusitis and recurrent acute rhinosinusitis are diagnosed based on symptoms and the presence of disease on either a sinus CT scan and/or endoscopy. Management of uncomplicated acute rhinosinusitis includes analgesics, saline irrigation, and/or intranasal steroids. Antibiotics and intranasal steroids are recommended for acute bacterial rhinosinusitis. Intranasal and oral steroids with antibiotics are recommended to treat chronic rhinosinusitis although the evidence for antibiotics is weak. Biologics such as omalizumab and mepolizumab are being investigated for the treatment of chronic rhinosinusitis with nasal polyps. Surgery may be indicated in management of refractory chronic rhinosinusitis and rarely for acute bacterial rhinosinusitis. This review discusses highlights of the updated 2014 practice parameter and up-to-date evidence from other literature sources.
在美国，鼻窦炎是一种常见的诊断疾病。鼻窦炎分为急性、复发性或慢性（伴有或不伴有鼻息肉）。急性鼻窦炎通过病史和体格检查诊断，而慢性鼻窦炎和复发性急性鼻窦炎则根据症状以及鼻窦 CT 扫描和/或内镜检查是否存在疾病来诊断。急性鼻窦炎的治疗包括镇痛药、盐水冲洗和/或鼻腔类固醇。对于急性细菌性鼻窦炎，推荐使用抗生素和鼻腔类固醇。尽管抗生素的证据较弱，但推荐使用鼻腔和口服类固醇加抗生素治疗慢性鼻窦炎。生物制剂，如奥马珠单抗和美泊利单抗，正在被研究用于治疗伴有鼻息肉的慢性鼻窦炎。手术可能适用于难治性慢性鼻窦炎的治疗，很少用于急性细菌性鼻窦炎。本综述讨论了 2014 年更新的实践参数中的要点以及来自其他文献来源的最新证据。
