Management of adult rhinosinusitis.

Rhinosinusitis is an inflammation of the nasal mucosa and paranasal sinuses, affecting more than 31 million Americans. Acute rhinosinusitis lasts up to 4 weeks and results from infection. Chronic rhinosinusitis lasts 12 or more weeks and is caused by various inflammatory processes. Symptoms may be similar, but management options differ.

Recognizing and treating non-infectious rhinitis.

PURPOSE: To increase clinicians' familiarity with nonallergic and mixed rhinitis and to differentiate these from allergic rhinitis, thus providing for an accurate diagnosis and facilitating a successful initial treatment program. DATA SOURCES: A Medline search of published journal articles was supplemented with known books and proceedings pertaining to rhinitis. CONCLUSIONS: Although there is significant overlap of symptoms among the three types of rhinitis (i.e., allergic, nonallergic, and mixed), the patient history often contains clues that can aid in establishing a correct diagnosis. The new Patient Rhinitis Screen, a questionnaire developed for use in the primary care arena, facilitates the diagnostic process. IMPLICATIONS FOR PRACTICE: As the most common condition in the outpatient practice of medicine, rhinitis is frequently treated by primary care practitioners. Recent guidelines for the diagnosis and management of rhinitis suggest that a specific diagnosis of allergic, nonallergic, or mixed rhinitis leads to more effective treatment strategies. The result is successful and efficient care utilizing, as appropriate, broad-based and symptom-specific therapies.