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From the JAMA Network
December 19, 2017

Diagnosis and First-Line Treatment of Chronic Sinusitis

Author Affiliations
  • 1Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
  • 2Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston
  • 3Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
JAMA. 2017;318(23):2344-2345. doi:10.1001/jama.2017.18196

Chronic sinusitis is a commonly diagnosed disease of the nose and sinuses, and is a distinct disease entity from acute sinusitis. Unlike acute sinusitis, chronic sinusitis it not primarily an infectious condition, but rather a chronic inflammatory process. Clinical practice guidelines (CPGs) from the American Academy of Otolaryngology-Head and Neck Surgery outline diagnostic and treatment recommendations, but above all else, emphasize the need for accurate diagnosis.1 Treatment for chronic sinusitis involves saline irrigation, nasal steroid spray, or both.1,2 Surgery is reserved for patients with severe or refractory disease. Although this and other CPGs for chronic sinusitis recommend long-term use of nasal steroid spray,3,4 few studies have examined the uptake of this recommendation.