Chronic rhinosinusitis: Epidemiology and medical management

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Presentation transcript:

Chronic rhinosinusitis: Epidemiology and medical management Daniel L. Hamilos, MD Journal of Allergy and Clinical Immunology Volume 128, Issue 4, Pages 693-707 (October 2011) DOI: 10.1016/j.jaci.2011.08.004 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Stepwise evaluation of the patient with CRS. RS, Rhinosinusitis. Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Evaluation and management of the patient with CRSsNP. IVIG, Intravenous immunoglobulin. Reproduced with permission from Mafee.118 Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Example of a patient with CRSsNP who received “intensive medical treatment” with antibiotics plus oral steroids. The left and right panels show the pretreatment and posttreatment sinus CT scans. Reproduced with permission from Subramanian et al.109 Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Evaluation and management of the patient with CRSwNP. MRI, Magnetic resonance imaging. Reproduced with permission from Mafee.118 Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Typical features of CRSwNP. A, Coronal sinus CT scan showing extensive polypoid mucosal thickening in the anterior ethmoid and maxillary sinuses bilaterally. The patient had previous FESS. B, Regrowth of polypoid tissue (ie, polyps) in the anterior ethmoid sinus viewed endoscopically. C, Polypoid tissue in the maxillary antrum viewed endoscopically. D, Gross appearance of nasal polyp removed from 1 nasal cavity. Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Evaluation and management of the patient with AFRS. IT, Immunotherapy; MRI, magnetic resonance imaging. Reproduced with permission from Mafee.118 Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 7 AFRS. Coronal CT scans showing opacified nasal cavities and paranasal sinuses. Note the “hyperdensities” within the opacified sinuses, as well as local and linear areas of increased density within the nasal cavities. Note also expansion of the right ethmoid caused by mucocele formation. Reproduced with permission from Mafee.118 Journal of Allergy and Clinical Immunology 2011 128, 693-707DOI: (10.1016/j.jaci.2011.08.004) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions