副鼻腔炎の診断と治療

抄録

Sinusitis is an inflammation of the paranasal sinuses characterized by respiratory symptoms such as nasal obstruction, purulent discharge, postnasal drip, cough, as well as other symptoms including headache, facial pain, and loss of smell. Acute bacterial sinusitis, which lasts less than 4 weeks, usually develops secondarily to the upper respiratory tract viral infection. It often cause facial pain which mimics the pain of the dental origin, so the patients may visit dental clinics. Acute bacterial sinusitis can be treated by administration of antibiotics. Chronic sinusitis, in which the symptoms continues for more than 3 months, often develops irreversible thickening of the nasal mucosa and/or polyps. It is multi factorial, caused by genetic, anatomic, and immunologic, and metabolic factors of each patient. It often needs additional treatment to antibiotics, such as low-dose macrolide therapy and endoscopic sinus surgery. There are special subtypes of chronic sinusitis such as eosinophilic, fungal, and odontogenic. In particular, eosinophilic sinusitis is refractory, and hold a big issue in rhinology.