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Chronic Sinusitis, What Doctors Don't Know


You can’t breathe through your nose, your face hurts, you have a throbbing headache, and your symptoms keep coming back. You likely have chronic sinusitis, and what doctors don’t know about this condition certainly doesn’t help.

Chronic Sinusitis

This common condition, also known as chronic rhinosinusitis, is one of the top five reasons why people visit their primary care doctor each year. The Centers for Disease Control and Prevention (CDC) estimates that 30.6 million noninstitutionalized Americans have sinusitis, while the American Academy of Asthma, Allergy and Immunology estimates that 12 percent of Americans younger than 45 have the chronic form of the disease.

Chronic sinusitis is defined as sinusitis that lasts more than eight weeks or keeps coming back. It may be caused by a bacterial or viral infection, growths in the sinuses, or a deviated nasal septum.

What Doctors Need To Know about Sinusitis
According to a new study by an internist at Georgetown University Medical Center, his colleagues have “scant and occasionally inaccurate” information about new developments and findings regarding chronic sinusitis. The result is that internists cannot adequately care for their patients who have this condition.

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Alexander C. Chester, MD, a clinical professor at GUMC and a practicing internist at Foxhall Internists based in Washington, DC, noted that “chronic sinusitis is an often debilitating illness with symptoms comparable to those of serious medical diseases.” One hurdle in treating this disease is that doctors often don’t know if the cause is bacterial or viral.

Although advances have been made in knowledge about the disease, Chester explained that the information is not getting to internists because it has not been published in sources often accessed by his colleagues. Therefore, an “out-of-sight, out-of-mind” attitude can result.

Chester noted that if physicians had better access to new information about chronic sinusitis, they could better treat their patients. He pointed out endoscopic sinus surgery in particular, which has replaced older procedures as an effective, safe treatment for patients who have chronic sinusitis that has not responded to other therapies.

Endoscopic sinus surgery involves use of state-of-the-art microtelescopes and other devices to remove obstructive and abnormal tissues. In most cases, the surgery can be performed entirely through the nostrils, leaving no external scars. Swelling and discomfort are minimal.

To remedy what doctors don’t know about chronic sinusitis, Chester urges “more studies, review articles, and evidence-based analyses need to be submitted for publication in general medical journals.” He believes papers on chronic sinusitis should be presented at general internal medicine meetings, not just specialty gatherings, and that communication between specialists and internists regarding chronic sinusitis needs to be facilitated.

American Academy of Asthma, Allergy and Immunology
Centers for Disease Control and Prevention
Georgetown University Medical Center