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December 10, 1997

Nasal Polyps and Sinusitis

JAMA. 1997;278(22):1849-1854. doi:10.1001/jama.1997.03550220055009

Despite the prevalence and long history of nasal polyps, many questions still exist with respect to incidence and pathogenesis. Although allergy has been commonly thought to be a major cause, much compelling evidence argues against this. Medical therapy consists of a short course of systemic steroids fol lowed by intranasal steroids. Sinusitis is the most commonly reported chronic disease in the United States. Decrease in ostial size, retention of secretions, and decrease in mucociliary action all contribute to the pathogenesis of sinusitis. The clinical presentation of chronic sinusitis is generally subtle and the clinical index of suspicion must be high. Limited coronal computed tomography is regarded as the most definitive and cost-effective imaging technique for the diagnosis of sinusitis. Appropriate antibiotics must be administered for a sufficient period. In medically resistant sinusitis, functional endoscopic sinus surgery has emerged as the procedure of choice.

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