Topic Overview
What is sinusitis?
Sinusitis is
infection or
inflammation of the lining of the sinus cavities.
These are hollow spaces in your cheeks and around your eyes. Sinus infections
often follow a cold and cause pain and pressure in your head and face.
Sinusitis can be either acute (sudden) or chronic (long-term). With
chronic sinusitis,
the infection or inflammation does
not completely go away for 8 weeks or more.
What causes sinusitis?
Sinusitis can be caused by
three things:
- Viruses.
- Bacteria.
-
Fungi.
The same viruses that cause the common cold cause most
cases of sinusitis.
When the lining of the sinus cavities gets
inflamed from a viral infection like a cold, it swells. This is viral
sinusitis. The swelling can block the normal drainage of fluid from the sinuses
into the nose and throat. If the fluid cannot drain and builds up over time,
bacteria or fungi (plural of fungus) may start to grow in it. These bacterial
or fungal infections can cause more swelling and pain. They are more likely to
last longer, get worse with time, and become chronic.
Nasal
allergies or other problems that block the nasal passages and allow fluid to
build up in the sinuses can also lead to sinusitis.
See a picture
of normal facial sinuses and a picture of a
blocked sinus.
What are the symptoms?
The main symptoms of
sinusitis are a runny or stuffy nose and pain and pressure in your head and
face. You may also have a yellow or green
drainage or drip from your nose or down the back of
your throat (postnasal discharge). Where you feel the pain and tenderness
depends on which sinus is affected.
Other common symptoms of
sinusitis may include:
- A headache.
- Bad
breath.
- A cough that produces
mucus.
- A fever.
- Pain in your
teeth.
- A reduced sense of taste or smell.
How is sinusitis diagnosed?
Your doctor can tell
if you have sinusitis by asking questions about your past health and doing a
physical exam. You probably won't need any other tests.
How is it treated?
Viral sinus infections usually
go away on their own within 10 to 14 days. Antibiotics don't work for viral
infections. But there are some things you can do at home to help relieve your
symptoms:
- Drink plenty of fluids.
- Try
over-the-counter pain relievers and decongestant pills
to help relieve the pain and pressure in your head and face.
- Put a
hot, damp towel or gel pack on your face for 5 to 10 minutes at a time, several
times a day.
- Breathe warm, moist air from a steamy shower, a hot
bath, or a sink filled with hot water.
- Use saltwater nose drops to keep the nasal passages moist and use saline nasal washes to help keep the nasal passages
open and wash out mucus and bacteria.
Home treatments may help drain mucus from the sinuses and
prevent a more serious bacterial or fungal infection.
Bacterial
infections can be treated with antibiotics. You will probably feel better in a
few days, but some symptoms may last for several weeks. You may need to take
the medicine for a longer time if you have chronic sinusitis.
If
you have a
fungal infection—which is not common—antibiotics won't
clear up your sinusitis. With this type of infection, you may need treatment
with antifungal medicines,
steroid medicines, or surgery.
If you
have taken antibiotics and other medicines for a long time but still have
sinusitis symptoms, you may need surgery. You may also need surgery if the
infection is likely to spread or if you have other problems, such as a growth
(polyp) blocking the nasal passage.
Frequently Asked Questions
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Cause
Sinusitis is
most often the result of a
viral infection that causes the
mucous membrane lining the inside of the nose and the
sinuses to become
inflamed.
- The mucous membrane swells when it becomes
inflamed, blocking the drainage of fluid from the sinuses into the nose and
throat.
- Mucus and fluid build up inside the
sinuses, causing pressure and pain.
- Bacteria are more likely to
grow in sinuses that are unable to drain properly.
Bacterial infection in the sinuses often causes more
inflammation and pain.
Colds usually trigger this process, but any factor that
causes the mucous membrane to become inflamed may lead to sinusitis. Many
people with nasal allergies (allergic rhinitis), for instance, are
likely to have recurring or long-term (chronic) sinus infections. Nasal
polyps, foreign objects (usually in children),
structural problems in the nose such as a
deviated septum, and other conditions can also block
the nasal passages, increasing the risk of sinusitis.
Fungal infections may also cause sinusitis. This is
especially true in people with
impaired immune systems. Fungal sinusitis tends to be
chronic and harder to treat than bacterial sinusitis.
Symptoms
Pain and pressure in the face along with a
stuffy or runny nose are the main symptoms of
sinusitis. You also may have a yellow or greenish
discharge from your nose. Leaning forward or moving your head often increases
facial pain and pressure.
The location of pain and tenderness may depend on
which sinus is affected. See a picture of the location of normal
facial sinuses.
Other common symptoms of sinusitis include:
- Headache.
- Yellow or greenish
discharge from the nose or down the back of the throat.
- Bad
breath.
- Stuffy nose.
- Cough that produces
mucus.
- Fever.
- Tooth
pain.
- Reduced sense of taste or smell.
Acute (sudden) sinusitis is usually caused by a
viral infection and often develops rapidly. It usually
lasts for 4 weeks or less, and the symptoms often begin to clear up within a
week without any treatment. Acute sinusitis caused by a
bacterial infection is less likely to clear up on its
own and may lead to chronic sinusitis or to complications in which the
infection spreads beyond the sinuses. Nasal discharge that contains pus and
gets worse after 5 days or persists for more than 10 days is usually a strong sign
of acute sinusitis caused by a bacterial infection.
Chronic
(long-term) sinusitis is usually caused by a bacterial or
fungal infection. These infections may be difficult to
treat. If chronic sinusitis is not cured after trying two or more different
antibiotics, you may want to talk with your doctor about surgery
or allergy testing. Chronic sinusitis can lead to permanent changes in the
mucous membranes that line the sinuses and may make
you more prone to sinus infections.
Symptoms of sinusitis in
children include coughing, nasal discharge that lasts more than 7 to 10 days,
and complaints of headache and facial pain. Many children age 2 or older with
chronic sinusitis may also have allergies and frequent ear infections. Some
immunizations, particularly pneumococcal conjugate
vaccine (PCV) and Haemophilus influenzae type b (Hib),
may help prevent ear and sinus infections.
Other conditions that have symptoms similar to sinusitis may include allergies, toothaches, and
colds or other
upper respiratory infections. But if you've had a cold
that returns or gets worse after 7 days (called double sickening), you probably
have a sinus infection rather than a cold or other upper respiratory
infection.
What Happens
There are two types of
sinusitis: acute (sudden onset) and chronic
(long-term). Sinusitis often develops after a cold or
viral infection. Most sinus infections improve on
their own, but sometimes they develop into a
bacterial infection—swelling, inflammation, and
mucus production caused by the cold can lead to
blockage in the nasal passages, which may encourage the growth of
bacteria.
Acute sinusitis, whether viral or bacterial, may develop
into chronic inflammation or infections that may last 8 weeks or longer.
Chronic sinusitis can lead to permanent changes in the
mucous membranes that line the sinuses. As a result of
these changes, you may become prone to having more sinus infections that may
become more difficult to treat.
Complications of sinusitis (such as an infection of the facial bones called
osteomyelitis) are relatively rare. But when
complications occur, they may be life-threatening and often require extensive
medical or surgical treatment.
What Increases Your Risk
Your risk of sinusitis increases if you have recently had a cold,
another
viral or
bacterial infection, or an
upper respiratory tract infection. Also, chronic nasal
allergies (allergic rhinitis) can lead to sinusitis.
Sometimes a
deviated septum, broken nose, or growths such as nasal
polyps can make you more susceptible to sinus
infections. Problems with nasal structure can prevent the proper flow of
mucus from the sinuses into the nose.
Other factors that increase your risk for getting sinus infections
include smoking, air pollution, overuse of decongestant sprays, cold weather,
rapid air pressure changes (such as from flying or scuba diving), and swimming
in contaminated water. Also, using
continuous positive airway pressure (CPAP) to treat
sleep apnea may increase the risk of sinusitis.
When To Call a Doctor
Call your doctor if
sinusitis does not improve after 2 days of home
treatment and you have symptoms such as:
- Pain in the face or upper
teeth.
- Pain extending from the bridge of the nose to the lower
eyelid.
- Headache that is not relieved by taking acetaminophen
or aspirin. (Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome).
Call your doctor after three or four days of
home treatment if you still have symptoms such as:
- Fever of
101°F (38.3°C) or
higher.
- Nasal discharge that starts out clear and later becomes
thick and discolored (yellow or green).
- Repeated nosebleeds.
You also need to call a doctor if:
- Cold symptoms last longer than 10 days or
get worse after the first 7 days.
- You have mild or chronic pain in the
face that lasts longer than a month, has changed, or has not been checked by a
doctor.
- You are taking antibiotics for a sinus infection, and you
do not feel any better after 3 to 5 days. You may need to try a different
antibiotic or add medicine that will reduce swelling to
your treatment.
If you are not sure whether you have a cold or a sinus
infection, see the topic
Facial Problems, Noninjury.
Watchful waiting
Watchful waiting is appropriate if you have
symptoms of an early sinus infection (such as pain and pressure in your head
along with a stuffy or runny nose). An early sinus infection can often be
treated at home if you are in good health. If you develop symptoms of a sinus
infection, start home treatment, such as drinking lots of fluids and breathing
steam from a warm shower, and use the guidelines above to decide whether you
need to call a doctor.
Who to see
Sinusitis may be
diagnosed by any of the following health professionals:
Your doctor may refer you to an
ear, nose, and throat (ENT) specialist (also called an
otolaryngologist) who can provide a more specialized
examination of the nasal passages and upper throat. Referral to an ENT
specialist may be beneficial for people in whom nasal polyps or other
conditions causing blockage of the nasal cavity are suspected. Diagnosis and
surgical treatment of chronic or complicated cases of sinusitis may be done by
an ENT specialist.
An
infectious disease specialist may be needed when
sinusitis is caused by something unusual or when rare
complications (such as an infection of the facial
bones) occur. An
allergist may be needed when allergies are suspected
to be causing or contributing to sinus problems.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Diagnosis of
sinusitis is usually based on your
medical history and
physical exam. A detailed history of the
problem often can be of more value to the diagnosis than a physical exam. If
the symptoms and physical findings are typical of sinusitis, further testing is
usually not needed.
Additional tests may be done if:
- The diagnosis is not
clear.
- Antibiotic treatment has failed to clear up the
problem.
- Complications (such as a bone infection) are
suspected.
- Surgery is being considered.
Imaging tests may be used when symptoms of sinusitis
persist or recur despite treatment, or to look for tumors or other growths when
there is bleeding or bloody discharge from the nose. They include:
- Computed tomography (CT) scan of the head and face, which provides a detailed image of sinus
structures. A CT scan may help evaluate severe or chronic sinusitis, identify
suspected complications of sinusitis, or rule out other conditions. It is not
used to diagnose acute sinusitis.
- Sinus X-ray, which
may be done to confirm a suspected case of sinusitis. An X-ray produces a
picture of dense tissues inside the body. But a CT scan may provide better
information.
Less often, other tests may be done by an ear, nose, and
throat (ENT) specialist (also called an
otolaryngologist) or by an
allergist. These tests may include:
Treatment Overview
Sinusitis is treated with
medicines and
home treatment methods, such as applying moist heat to
your face. The goals of treatment for
sinusitis are to:
- Improve drainage of mucus and reduce swelling
in the sinuses.
- Relieve pain and pressure.
- Clear up any
infection.
- Prevent the formation of scar tissue, and avoid
permanent damage to the tissues lining the nose and sinuses.
Medicines may be used to treat sinusitis, especially when
it is caused by a
bacterial infection. There are varying lengths of
treatment with medicines—treatment may be as short as three days or last as
long as several weeks or more. Medicines most often used to treat sinusitis
include a combination of:
- Antibiotics, such as amoxicillin,
which kill bacteria.
- Decongestants, such as pseudoephedrine, which reduce the swelling of the mucous membranes in the
nose.
- Analgesics, such as acetaminophen or
ibuprofen, to relieve pain.
- Mucolytics, such as
guaifenesin, which thin the mucus.
- Corticosteroids, such as beclomethasone
or prednisone, which reduce inflammation in the nasal passages. Some corticosteroids are used as an inhaled nasal spray.
It is possible
to develop "double sickening" while being treated for acute or chronic
sinusitis. At first, you may begin to feel better from antibiotics and home
treatment, but then your symptoms become worse and additional treatment may be
needed.
For more information, see:
Sinusitis: Should I Take Antibiotics?
For acute sinusitis
Short-term (acute) sinusitis
usually lasts less than 4 weeks. Up to two-thirds of people with acute
sinusitis improve on their own without antibiotic treatment.1 Sinus infections are commonly caused by
viral infections, which do not respond to antibiotics. Talking with
your doctor will help you determine whether treatment with
antibiotics is needed for your acute sinus infection.
Most people recover completely when treated with an antibiotic for acute
sinusitis that is caused by a bacterial infection. The number of days you take
antibiotics depends on the antibiotic and how bad the infection is. When
you are prescribed an antibiotic, be sure to take it until it is gone, even if
you feel better. Always take an antibiotic exactly as your doctor tells you, or the infection may not go away
completely.
For chronic sinusitis
Sinusitis that lasts 8 weeks
or longer is called chronic sinusitis. It is more difficult to treat and
responds more slowly to antibiotics than acute sinusitis.
Antibiotic therapy is usually recommended for chronic sinusitis and may
require a longer course of treatment. You may need to try more than one
antibiotic. A
corticosteroid nasal spray that reduces
inflammation and swelling of the lining of the nasal
passages may also be used during treatment.
In some people, a
sinus infection may be caused by a
fungus or a bacterium other than those normally
associated with sinusitis. People who have an
impaired immune system are at risk for these unusual
infections. It also may include people who must use an oral or inhaled
corticosteroid medication (such as prednisone). Fungal sinusitis, which
accounts for a significant number of chronic sinusitis cases, does not respond
to antibiotic treatment and may need treatment with antifungal medications,
corticosteroids, or surgery.
Surgery may be required if you have
taken antibiotics for an extended period of time but still have symptoms or
when complications (such as infection of facial bones) are
likely. For more information, see:
- Sinusitis: Should I Have Surgery?
What to think about
Sinusitis may be difficult to
diagnose, because it often causes the same symptoms as a cold or other viral
illness, especially in its early stages. It can be particularly difficult to
identify sinusitis in children. If your child or you have frequent sinus
infections, learn what signs to watch for, and begin home treatment
immediately.
Symptoms of chronic sinusitis are often vague and may
not respond well to treatment. It may take time and patience to find a
successful treatment.
Prevention
There are several ways you may reduce your
chance of getting
sinusitis:
- Treat stuffiness (nasal congestion) caused by
colds or allergies promptly. This can help you prevent a
bacterial infection from developing in your sinuses.
- Avoid contact with people who have colds and other
viral upper respiratory infections. If you do have
contact with people who have these infections, wash your hands often,
especially after being in contact with those who are
infected.
- Avoid cigarette, cigar, and pipe smoke in your home and
workplace. Smoke causes and further irritates inflamed membranes in your nose
and sinuses.
- If you have allergies, avoid the things that trigger
your allergy attacks. Consider talking to your doctor about
allergy shots (immunotherapy). For more information,
see the topic
Allergic Rhinitis.
- Avoid breathing dry
air. Consider using a humidifier at home and work to increase the moisture in
the air.
Home Treatment
Home treatment may relieve symptoms of
pain and pressure associated with short-term (acute)
sinusitis. Home treatment may improve drainage of
mucus from the sinuses and prevent the need for
antibiotics.
- Drink plenty of fluids to help keep your
mucus thin.
- Apply moist heat (using a hot,
damp towel or gel pack) to your face for 5 to 10 minutes, several times a
day.
- Breathe warm, moist air from a steamy shower, a hot bath, or a
sink filled with hot water. Avoid extremely cool, dry air. Consider using a
humidifier to increase the moisture in the air in your home.
- Use
saltwater nasal washes (saline lavage or irrigation)
to help keep the nasal passages open and wash out mucus and bacteria. You can
purchase saline nose drops at a pharmacy or make your own saline solution at
home. If you make saline at home, use distilled water or water that has been boiled and then cooled. It may also help to gargle with warm salt water.
- Try
over-the-counter medicines such as pain relievers and
decongestants (for example, nasal spray) to relieve symptoms. Cough and cold medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight. Be
careful when using some nasal-spray decongestants. They usually should not be used for more than about 3
days. Longer use can lead to further swelling of the sinus membranes after the medicine wears off (called
rebound congestion), which makes pressure and swelling worse. You may end up dependent on the medicine
if you start using more and more of it to get rid of the pressure and swelling.
- If you need to
blow your nose, do it gently. Forceful blowing may force thick mucus back into
your sinuses and block them. Keep both nostrils open when blowing your
nose.
If you have chronic sinusitis, you'll probably need to
continue the above home treatment measures for a long period of time to keep
your sinuses clear.
Medications
Medicines may be needed when symptoms of
sinusitis are severe or do not improve. The goals of
treatment with medicine are to:
- Treat the infection, which is usually caused by
bacteria if your symptoms have lasted more than 7 to 10
days.
- Relieve pressure and pain caused by poor sinus
drainage.
- Reduce
inflammation of the nose and sinuses.
Medication choices
Medicines are used and sometimes combined to treat
sinusitis.
- Antibiotics kill bacteria. Examples of
antibiotics used are amoxicillin and cefdinir
(Omnicef).
- Decongestants reduce the swelling of the mucous
membranes in the nose. Some examples may include oxymetazoline
(for example, Afrin) and phenylephrine (for example, Neo-Synephrine).
- Analgesics relieve pain. Some examples include acetaminophen (for example, Tylenol) and
ibuprofen (for example, Advil).
- Corticosteroids reduce inflammation in the nasal
passages. Some examples include beclomethasone (Beconase) or mometasone (Nasonex).
- Mucolytics thin mucus. Some examples include guaifenesin (for example, Robitussin).
What to think about
If you are taking antibiotics
for a sinus infection, do not stop taking the antibiotics early just because
you feel better. Take the entire course of antibiotics. The infection may not
go away if you do not take all of the antibiotics prescribed by your doctor.
Antibiotic treatment is successful in most cases of
short-term (acute) sinusitis when it is caused by
bacteria. You should notice improvement within 3 to 4
days after you begin taking an antibiotic.
Chronic sinusitis may last 8 weeks or longer and usually
requires 3 to 4 weeks of antibiotic treatment. Symptoms may persist or return
despite adequate antibiotic treatment. A different antibiotic may be needed to
treat the infection. Referral to an ear, nose, and throat (ENT) specialist
(also called an
otolaryngologist) may be needed if symptoms of
sinusitis do not go away despite long-term antibiotic treatment.
For more information, see:
- Sinusitis: Should I Take Antibiotics?
Surgery
The goal of surgery is to
make drainage of the
sinuses better, usually by removing the blockage and
draining the mucus. This may mean removing:
- Infected, swollen, or damaged
tissue.
- Bone, to create a wider opening for drainage of mucus from
the sinuses.
- Growths (polyps) inside
the nose or sinuses.
- A foreign object that is blocking a nasal or
sinus passage. This usually occurs in children.
Surgery may be the only means of getting a badly blocked,
infected sinus to drain properly. But surgery does not always completely
eliminate sinusitis. Some people may need a second operation.
Surgery is most successful when used along with medicine and home
treatment to prevent future sinusitis. A second surgery and future sinusitis
may be avoided if antibiotics are taken to prevent reinfection.
For more information on when surgery is a good choice, see:
- Sinusitis: Should I Have Surgery?
Surgery choices
Endoscopic surgery is preferred over traditional surgery
for most cases of chronic sinusitis that require surgery. It is less invasive,
less expensive, and has a lower rate of complications.
- Endoscopic surgery may be done to remove small amounts
of bone or other material blocking the sinus openings or to remove growths
(polyps). Normally, a thin, lighted tool called an endoscope is inserted
through the nose so the doctor can see and remove whatever is blocking the
sinuses.
- Traditional surgery may be done when
complications of sinusitis—such as the development of pus in a sinus, infection
of the facial bones, or brain
abscess—have occurred. In this type of surgery, the
doctor makes an opening into the sinus from inside the mouth or through the
skin of the face.
What to think about
Very few
people need surgery to treat sinusitis. But you may need surgery if
ALL of these are true:
- Your doctor says that you have chronic
sinusitis.
- You've followed what's called "maximum medical
treatment" for 4 to 6 weeks. This means that you've taken medicines and
followed home treatment for at least 4 to 6 weeks. This treatment includes
antibiotics, a
steroid nasal spray, and other prescription
medicines.
- You've had a
CT scan of your sinuses after the 4 to 6 weeks of
treatment. It is very important to have the CT scan done after this treatment. Reducing the swelling and infection as
much as possible lets your doctor see what could be causing your
infections.
- The CT scan shows that something is keeping your
sinuses from draining as they should.
You also may need surgery if:
- You have a sinus infection caused by a
fungus. Infections caused by fungus cannot be cleared up with
antibiotics.
- You have a serious problem such as an infection that
spreads beyond your sinuses. This is rare.
The extent of the blockage and other problems determine
how extensive your surgery will need to be. Surgery may be limited to removal
of infected tissue or small growths (polyps) inside the nose. More extensive
surgery involves removing pieces of bone to create a wider opening to allow a
sinus to drain.
Sinus surgery is always performed by an ear, nose,
and throat (ENT) specialist (also called an
otolaryngologist).
Other Treatment
There is no other medical
treatment for
sinusitis at this time.
Other Places To Get Help
Organizations
|
Centers for Disease Control and Prevention
|
| |
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| USA |
| |
| Phone: |
1-800-CDC-INFO (1-800-232-4636)
|
| TDD: |
1-888-232-6348 |
| Email: |
cdcinfo@cdc.gov |
| Web Address: |
www.cdc.gov/getsmart |
| |
|
The Get Smart Web site at the Centers for Disease Control and Prevention (CDC) provides information for both consumers and health professionals on the appropriate use of antibiotics. The Web site explains the dangers of inappropriate use of antibiotics and gives tips on actions people can take to feel better if they have an infection that cannot be helped by antibiotics. Some materials are available in English and in Spanish.
|
|
| American Academy of Allergy, Asthma, and
Immunology |
| 555 East Wells Street |
| Suite 1100 |
| Milwaukee, WI 53202-3823 |
| Phone: |
(414) 272-6071 |
| Email: |
info@aaaai.org |
| Web Address: |
www.aaaai.org |
| |
|
The American Academy of Allergy, Asthma, and Immunology
publishes an excellent series of pamphlets on allergies, asthma, and related
information. It also provides physician referrals.
|
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| American Academy of Otolaryngology—Head and Neck Surgery
(AAO-HNS) |
| 1650 Diagonal Road |
| Alexandria, VA 22314-2857 |
| Phone: |
(703) 836-4444 |
| Web Address: |
www.entnet.org |
| |
|
The American Academy of Otolaryngology—Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
|
|
| KidsHealth for Parents, Children, and
Teens |
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: |
(904) 697-4100 |
| Fax: |
(904) 697-4220 |
| Web Address: |
www.kidshealth.org |
| |
|
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
|
|
| National Institute of Allergy and Infectious Diseases
(NIAID), National Institutes of Health |
| NIAID Office of Communications and Government Relations |
| 6610 Rockledge Drive, MSC 6612 |
| Bethesda, MD 20892-6612 |
| Phone: |
1-866-284-4107 toll-free |
| Phone: |
(301) 496-5717 |
| Fax: |
(301) 402-3573 |
| TDD: |
1-800-877-8339 |
| Web Address: |
www.niaid.nih.gov |
| |
|
The National Institute of Allergy and Infectious
Diseases conducts research and provides consumer information on infectious and
immune-system-related diseases.
|
|
References
Citations
- Ah-See, K (2008). Sinusitis (acute), search date
August 2007. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
Other Works Consulted
- Joint Task Force on Practice Parameters in
Allergy, Asthma, and Immunology (1998). Diagnosis and management of rhinitis:
Complete guidelines of the Joint Task Force on Practice Parameters in Allergy,
Asthma, and Immunology. Annals of Allergy, Asthma, and Immunology, 81(5, Part 2): 478–518.
- Lane AP, Kennedy DW (2003). Sinusitis and polyposis.
In JB Snow Jr et al., eds., Ballenger's Otorhinolaryngology Head and Neck Surgery, 16th ed., pp. 760–787. Hamilton, ON: BC
Decker.
- Rosenfeld R, Andes D et al (2007). Clinical practice
guideline: Adult sinusitis. 137:S1-S31 Otolaryngology—Head and Neck Surgery. 137:S1-S31
Credits
| By |
Healthwise Staff |
| Primary Medical Reviewer |
Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer |
Donald R. Mintz, MD - Otolaryngology |
| Last Revised |
February 8, 2012 |
