Sinusitis and Pharyngitis

  • Paul Evans
  • William F. Miser


Sinusitis, or rhinosinusitis, is a common problem, with 25 million office visits per year in the United States and over $7 billion in direct costs.1 It is primarily caused by ostial obstruction of the anterior ethmoid and middle meatal complex due to retained secretions, edema, or polyps. Barotrauma, nasal cannulation, or ciliary transport defects can also precipitate infection.2 Most sinusitis is handled well at the primary care level; there appear to be few discernible differences in technical efficiency between generalists and specialists in its treatment.3


Sore Throat Frontal Sinus Primary Ciliary Dyskinesia Acute Rheumatic Fever Functional Endoscopic Sinus Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Stewart M, Siff J, Cydulka R. Evaluation of the patient with sore throat, earache, and sinusitis: an evidence-based approach. Em Med Clin North Am 1999; 17 (1): 153–87.CrossRefGoogle Scholar
  2. 2.
    Linden B, Aguilar E, Allen S. Sinusitis in the nasotracheally intubated patient. Arch Otolaryngol Head Neck Surg 1988; 114: 860–1.PubMedCrossRefGoogle Scholar
  3. 3.
    Ozcan Y, Jiang H, Pai C. Do primary care physicians or specialists provide more efficient care? Health Sery Manag Res 2000; 13 (2): 90–6.Google Scholar
  4. 4.
    Lanza D, Kennedy D. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997; 117: S1–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Hadley J, Schafer S. Clinical evaluation of rhinosinusitis: history and physical examination. Otolaryngol Head Neck Surg 1997; 117: S8–11.PubMedCrossRefGoogle Scholar
  6. 6.
    Kormos WA. Approach to the patient with sinusitis. In Goroll AH, May LA, Mulley AG, eds. Primary care medicine 4th ed. Philadelphia: JB Lippincott; 2000: 1127–8.Google Scholar
  7. 7.
    Way L. Current surgical diagnosis and treatment, 10th ed. East Norwalk, CT: Appleton & Lange, 1994.Google Scholar
  8. 8.
    Ferguson B. Acute and chronic sinusitis-how to ease symptoms and locate the cause. Postgrad Med 1995; 97 (5): 45–57.PubMedGoogle Scholar
  9. 9.
    Tierney L, McPhee S, Papadakis M. Current medical diagnosis and treatment, 34th ed. East Norwalk, CT: Appleton & Lange, 1995.Google Scholar
  10. 10.
    Burke T, Guertler A, Timmons J. Comparisons of sinus x-rays with CT scans in acute sinusitis. Acad Emerg Med 1994; 1 (3): 235–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Hopp R, Cooperstock M. Evaluation and treatment of sinusitis: aspects for the managed care environment. JAOA 1996; 96 (4 suppl): S6–10.Google Scholar
  12. 12.
    Bhattacharyya T, Piccinillo J, Wippold F. Relationship between patient-based description of sinusitis and paranasal sinus CT findings. Arch Otolaryngol Head Neck Surg 1997; 123: 1189–92.PubMedCrossRefGoogle Scholar
  13. 13.
    Sanford J, Gilbert D, Sande M. Sanford’s guide to antimicrobial therapy, 26th ed. Dallas: Antimicrobial Therapy, 1996.Google Scholar
  14. 14.
    Nord C. The role of anaerobic bacteria in recurrent episodes of sinusitis and tonsillitis. Clin Infect Dis 1995; 20: 1512–24.PubMedCrossRefGoogle Scholar
  15. 15.
    Decker C. Sinusitis in the immunocompromised host. Curr Infect Dis Rep 1999; 1 (1): 27–32.PubMedCrossRefGoogle Scholar
  16. 16.
    Kormos WA. Approach to the patient with sinusitis. In Goroll AH, May LA, Mulley AG, eds. Primary care medicine 4th ed. Philadelphia: JB Lippincott; 2000: 1127.Google Scholar
  17. 17.
    Ray N. Healthcare expenditures for sinusitis in 1996: contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol 1999; 103 (3 pt 1): 408–14.PubMedCrossRefGoogle Scholar
  18. 18.
    Snow V, Mottur-Pilson C JMJH. Princples of appropriate antibiotic use for acute sinusitis in adults. Ann Intern Med 2001; 134: 495–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Holten K, Onusko E. Appropriate prescribing of oral beta-lactam antibiotics. Am Fam Physician 2000; 62: 611–20.PubMedGoogle Scholar
  20. 20.
    Gilbert D, Moelleering R, Sande M. The Sanford’s guide to antimicrobial therapy, 31st ed. Dallas,TX: Antimicrobial Therapy. 2001.Google Scholar
  21. 21.
    Taccariello M, Parikh A, Darby Y, Scadding G. Nasal douching as a valuable adjunct in the management of chronic rhinosinusitis. Rhinology 1999; 37 (1): 29–32.PubMedGoogle Scholar
  22. 22.
    Malm L. Pharmacological background to decongesting and anti-inflammatory treatment of rhinitis and sinusitis. Acta Otolaryngol Suppl (Stockh)I994;5I5:53–5.Google Scholar
  23. 23.
    Naclerio R. Allergic rhinitis. N Engl J Med 1991; 325: 860–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Parsons DS, Wilder BE. Rhinitis and sinusitis (acute and chronic). In: Burg TD, Ingelfinger JR, Wald ER, Polin RA, eds. Current pediatric therapy 16th ed. Philadelphia: WB Saunders, 1999: 506–7.Google Scholar
  25. 25.
    Mellen I. Chronic sinusitis: clinical and pathophysiological aspects. Acta Otolaryngol Suppl (Stockh) 1994; 515: 45–8.CrossRefGoogle Scholar
  26. 26.
    Dunand V, Hammer S, Rossi R, et al. Parasitic sinusitis and otitis in patients infected with human immunodeficiency virus: report of five cases and review. Clin Infect Dis 1997; 25 (2): 267–72.PubMedCrossRefGoogle Scholar
  27. 27.
    Osguthorp J. Adult rhinosinusitis: diagnosis and management. Am Fam Physician 2001; 63: 69–76.Google Scholar
  28. 28.
    Metson R, Gliklich R. Clinical outcomes in patients with chronic sinusitis. Laryngoscope 2000; 110 (3 pt 3): 24–8.PubMedCrossRefGoogle Scholar
  29. 29.
    Slack R, Bates G. Functional endoscopie sinus surgery. Am Fam Physician 1998; 58: 707–18.PubMedGoogle Scholar
  30. 30.
    Deda G, Caksen H, Ocal A. Headache etiology in children: a retrospective study of 125 cases. Pediatr Int 2000; 42: 668–73.PubMedCrossRefGoogle Scholar
  31. 31.
    Cunningham J, Chiu E, Landgraf J, Gliklich R. The health impact of chronic recurrent rhinosinusitis in children. Arch Otolaryngol Head Neck Surg 2000; 126 (11): 1363–8.PubMedGoogle Scholar
  32. 32.
    Lasley M, Shapiro G. Rhinitis and sinusitis in children. Immunol Allerg Clin North Am 1999; 19: 437–52.CrossRefGoogle Scholar
  33. 33.
    Konen E, Faibel M, Kleinbaum Y, et al. The value of the occipitomental (Waters’) view in diagnosis of sinusitis: a comparative study with computed tomography. Clin Radio! 2000; 55: 856–60.CrossRefGoogle Scholar
  34. 34.
    Diaz I, Bamberger D. Acute sinusitis. Semin Respir Infect 1995; 10: 14–20.PubMedGoogle Scholar
  35. 35.
    Ebell M, Smith M, Barry H, Ives K, Carey M. Does this patient have strep throat? JAMA 2000; 284: 2912–8.PubMedCrossRefGoogle Scholar
  36. 36.
    Bisno A. Acute pharyngitis. N Engl J Med 2001;344:205–11. Kiselica D. Group A beta-hemolytic streptococcal pharyngitis: current clinical concepts. Am Fam Physician 1994; 49 (5): 1147–54.Google Scholar
  37. 37.
    Pichichero M. Group A streptococcal tonsillopharyngitis: cost-effective diagnosis and treatment. Ann Emerg Med 1995; 25 (3): 390–403.PubMedCrossRefGoogle Scholar
  38. 38.
    Kline J, Runge J. Streptococcal pharyngitis: a review of pathophysiology, diagnosis, and management. J Emerg Med 1994; 12 (5): 665–80.PubMedCrossRefGoogle Scholar
  39. 39.
    Epperly T, Wood T. New trends in the management of peritonsillar abscess. Am Fam Physician 1990; 42: 102–12.PubMedGoogle Scholar
  40. 40.
    Ahmed K, Jones A, Shah K, Smethurst A. The role of ultrasound in the management of peritonsillar abscess. J Laryngol Otol 1994; 108: 610–2.PubMedCrossRefGoogle Scholar
  41. 41.
    Patel K, Ahmad S, O’Leary G, Michel M. The role of computed tomography in the management of peritonsillar abscess. Otolaryngol Head Neck Surg 1992; 107: 727–32.PubMedGoogle Scholar
  42. 42.
    Richardson M. Sore throat, tonsillitis, and adenoiditis. Med Clin North Am 1999; 83 (1): 75–83.PubMedCrossRefGoogle Scholar
  43. 43.
    Gerber M, Tanz R. New approaches to the treatment of group A streptococcal pharyngitis. Curr Opin Pediatr 2001; 13 (1): 51–5.PubMedCrossRefGoogle Scholar
  44. 44.
    Adam D, Scholz H, Helmerking M. Short-course antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae. Clin Infect Dis 2000; 182: 509–16.Google Scholar
  45. 45.
    Bisno A, Gerber M, Gwaltney J, Kaplan E, Schwartz R. Diagnosis and management of group A streptococcal pharyngitis: a practice guideline. Clin Infect Dis 1997; 25: 574–83.PubMedCrossRefGoogle Scholar
  46. 46.
    Green S. Acute pharyngitis: the case for empiric antimicrobial therapy. Ann Emerg Med 1995; 25 (3): 404–6.PubMedGoogle Scholar
  47. 47.
    Pinchichero M, Casey J, Mayes T, et al. Penicillin failure in streptococcal tonsillopharyngitis: causes and remedies. Pediatr Infect Dis J 2000; 19: 917–23.CrossRefGoogle Scholar
  48. 48.
    Wilson K, Maroney S, Gander R. The family pet as an unlikely source of group A beta-hemolytic streptococcal infection in humans. Pediatr Infect Dis J 1995; 14: 372–5.PubMedCrossRefGoogle Scholar
  49. 49.
    Gerber M. Treatment failures and carriers: perception or problems? Pediatr Infect Dis J 1994; 13: 576–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Hayes C, Williamson H. Management of group A beta-hemolytic streptococcal pharyngitis. Am Fam Physician 2001; 63: 1557–64.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Paul Evans
  • William F. Miser

There are no affiliations available

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