Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Guidelines for Sinusitis Agreed to by Allergists, Otolaryngologist - Head and Neck Surgeons

07.12.2004


Rhinosinusitis, the inflammation of the mucous membrane of the nose and sinuses, has increased in both prevalence and incidence. Health officials believe that this disorder, also known as sinusitis, causes significant physical symptoms, negatively affects quality of life, and can substantially impair daily functions. It is now estimated that rhinosinusitis affects approximately 31 million Americans each year.



Recognizing a need for evidence-based rhinosinusitis guidelines, five national societies,The American Academy of Allergy, Asthma and Immunology (AAAAI); The American Academy of Otolaryngic Allergy; The American Academy of Otolaryngology -- Head and Neck Surgery (AAO-HNS); The American College of Allergy, Asthma and Immunology; and the American Rhinologic Society convened a panel of 30 physicians from a wide range of disciplines to develop definitions of rhinosinusitis for clinical research, and suggest clinical trial designs for studies that would allow for more appropriate use of pharmacologic, immunologic, and surgical interventions.

For the clinician, existing definitions of the disease fail to describe all manifestations of rhinosinusitis. This is due, in part, to the numerous causes of rhinosinusitis, which can be viral, bacterial, fungal, allergic, and for some patients, of unknown origin. Rhinosinusitis can be acute or chronic (the latter defined by the Sinus and Allergy Health Partnership as “a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks’ duration." (Otolaryngology Head and Neck Surgery, September 2003)). Other classes i.e., subacute, recurrent acute, acute exacerbation of chronic, community acquired bacterial, and nosocomial, have been used in medical literature.


“We believed that the lack of a consensus definition for chronic rhinosinusitis hampered efforts to conduct research studies or to attempt studies of medical treatment,” agreed Eli O. Meltzer, MD, a member of the AAAAI’s Sinusitis Committee and James Hadley, MD, Past President of both the AAOA and ARS.

Their findings are provided in a supplement, “Rhinosinusitis: Establishing Definitions for Clinical Research and Patient Care,” published concurrently in the December 2004 editions of the Journal of Allergy & Clinical Immunology (JACI) http://www.mosby.com/jaci/ and Otolaryngology – Head and Neck Surgery (OTO-HNS) http://www.mosby.com/oto/. The corresponding author is Eli O. Meltzer, MD, Co-Director, Allergy and Asthma Medical Group and Research Center, San Diego, CA.

Findings: After two days of meeting, this panel was able to reach consensus (more than 80 percent of committee members) on definitions and clinical research strategies for acute (bacterial) rhinosinusitis, chronic rhinosinusitis without polyps, chronic rhinosinusitis with polyps, and allergic fungal rhinosinusitis. Other conclusions reached were:

* No one etiologic factor fully explains or adequately accounts for the pathologic manifestations and clinical differences found in rhinosinusitis. The inflammatory component of these disorders manifests as a mixed mononuclear inflammatory cell infiltrate with neutrophils predominating in acute disease and eosinophils predominating in most chronic disease.

* Chronic rhinosinusitis has a significant inflammatory component that may be caused simultaneously or independently by various factors. These include but are not restricted to the possible roles of: persistent infection as a factor in chronic rhinosinusitis including biofilms and “osteitis” (inflammation of the bone); allergy and other disorders of immunity; intrinsic factors of the upper airway; super antigens from Staphylococcus aureus in chronic rhinosinusitis with nasal polyps; colonizing fungi that induce and sustain eosinophilic inflammation; and metabolic perturbations such as aspirin sensitivity.

The panel agreed on consensus definitions for rhinosinusitis as applied to (1) acute presumed bacterial rhinosinusitis; (2) chronic rhinosinusitis without polyps; (3) chronic rhinosinusitis with polyps; and (4) classic allergic fungal rhinosinusitis. Additionally, initial proposals were made for clinical trial designs, including an outline of suggested subjective and objective assessments applicable to these studies.

Conclusions: The definitions and guidelines outlined in “Rhinosinusitis: Establishing Definitions for Clinical Research and Patient Care,” will be invaluable to physicians who diagnose and treat sinusitis and the clinicians and researchers responsible for developing and implementing appropriate clinical studies.

The work of this important consensus panel will serve as a catalyst for further research of this debilitating disorder. But the participants in this effort agree that 1) promoting more research on both acute and chronic rhinosinusitis is essential; 2) a better understanding of the cause of these diseases is needed; 3) study designs for the evaluation of potential therapeutic modalities for rhinosinusitis, as well as appropriate outcome studies must be carefully considered.

The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the AAAAI has nearly 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information through its Web site at http://www.aaaai.org.

The American Academy of Otolaryngology – Head and Neck Surgery http://www.entnet.org, one of the oldest medical associations in the nation, represents more than 10,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization’s mission is: “Working for the Best Ear, Nose, and Throat Care.”

| newswise
Further information:
http://www.aaaai.org
http://www.entnet.org

More articles from Health and Medicine:

nachricht Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine

nachricht Flexible sensors can detect movement in GI tract
11.10.2017 | Massachusetts Institute of Technology

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Ocean atmosphere rife with microbes

17.10.2017 | Life Sciences

Neutrons observe vitamin B6-dependent enzyme activity useful for drug development

17.10.2017 | Life Sciences

NASA finds newly formed tropical storm lan over open waters

17.10.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>