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Published in: BMC Ear, Nose and Throat Disorders 1/2012

Open Access 01-12-2012 | Commentary

Canadian guidelines for rhinosinusitis: practical tools for the busy clinician

Author: Shaun Kilty

Published in: BMC Ear, Nose and Throat Disorders | Issue 1/2012

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Abstract

Acute bacterial rhinosinusitis (ABRS) and chronic rhinosinusitis (CRS) frequently present in clinical practice. Guidelines for management of these conditions have been published extensively in the past. However, a set of guidelines that addressed issues specific to the Canadian environment while offering clear guidance for first-line clinicians was needed, and resulted in the recent publication of Canadian clinical practice guidelines for ABRS and CRS. In addition to addressing issues specific to Canadian physicians, the presented guidelines are applicable internationally, and offer single algorithms for the diagnosis and management of ABRS and CRS, as well as expert opinion in areas that do not have an extensive evidence base. This commentary presents major points from the guidelines, as well as the intended impact of the guidelines on clinical practice.
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Literature
1.
go back to reference Desrosiers M, Evans GA, Keith PK, Wright ED, Kaplan A, Bouchard J, Ciavarella A, Doyle PW, Javer AR, Leith ES: Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol. 7: 2- Desrosiers M, Evans GA, Keith PK, Wright ED, Kaplan A, Bouchard J, Ciavarella A, Doyle PW, Javer AR, Leith ES: Canadian clinical practice guidelines for acute and chronic rhinosinusitis. Allergy Asthma Clin Immunol. 7: 2-
2.
go back to reference Desrosiers M, Evans GA, Keith PK, Wright ED, Kaplan A, Bouchard J, Ciavarella A, Doyle PW, Javer AR, Leith ES: Canadian clinical practice guidelines for acute and chronic rhinosinusitis. J Otolaryngol Head Neck Surg. 2011, 40 (Suppl 2): S99-193.PubMed Desrosiers M, Evans GA, Keith PK, Wright ED, Kaplan A, Bouchard J, Ciavarella A, Doyle PW, Javer AR, Leith ES: Canadian clinical practice guidelines for acute and chronic rhinosinusitis. J Otolaryngol Head Neck Surg. 2011, 40 (Suppl 2): S99-193.PubMed
3.
go back to reference Fokkens W, Lund V, Mullol J: European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl. 2007, 1-136. Fokkens W, Lund V, Mullol J: European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl. 2007, 1-136.
4.
go back to reference Scadding GK, Durham SR, Mirakian R, Jones NS, Leech SC, Farooque S, Ryan D, Walker SM, Clark AT, Dixon TA: BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008, 38: 19-42.CrossRefPubMed Scadding GK, Durham SR, Mirakian R, Jones NS, Leech SC, Farooque S, Ryan D, Walker SM, Clark AT, Dixon TA: BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008, 38: 19-42.CrossRefPubMed
5.
go back to reference Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, Gelzer A, Hamilos D, Haydon RC, Hudgins PA: Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2007, 137: S1-31. 10.1016/j.otohns.2007.06.726.CrossRefPubMed Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, Gelzer A, Hamilos D, Haydon RC, Hudgins PA: Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2007, 137: S1-31. 10.1016/j.otohns.2007.06.726.CrossRefPubMed
6.
go back to reference Scadding GK, Durham SR, Mirakian R, Jones NS, Drake-Lee AB, Ryan D, Dixon TA, Huber PA, Nasser SM: BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy. 2008, 38: 260-275.CrossRefPubMed Scadding GK, Durham SR, Mirakian R, Jones NS, Drake-Lee AB, Ryan D, Dixon TA, Huber PA, Nasser SM: BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy. 2008, 38: 260-275.CrossRefPubMed
7.
go back to reference Desrosiers M, Frenkiel S, Hamid QA, Low D, Small P, Carr S, Hawke M, Kirkpatrick D, Lavigne F, Mandell L: Acute bacterial sinusitis in adults: management in the primary care setting. J Otolaryngol. 2002, 31 (Suppl 2): 2S2-14.PubMed Desrosiers M, Frenkiel S, Hamid QA, Low D, Small P, Carr S, Hawke M, Kirkpatrick D, Lavigne F, Mandell L: Acute bacterial sinusitis in adults: management in the primary care setting. J Otolaryngol. 2002, 31 (Suppl 2): 2S2-14.PubMed
9.
go back to reference Pleis J, Lucas J: Summary health statistics for U.S. adults: National Health Interview Survey, 2007. National Center for Health Statistics. Vital Health Stat. 2009, 10: Pleis J, Lucas J: Summary health statistics for U.S. adults: National Health Interview Survey, 2007. National Center for Health Statistics. Vital Health Stat. 2009, 10:
10.
go back to reference Pleis JR, Ward BW, Lucas JW: Summary health statistics for U.S. adults: National Health Interview Survey, 2009. 2010, Hyattsville, MD: National Center for Health Statistics, Series 10, No. 249 Pleis JR, Ward BW, Lucas JW: Summary health statistics for U.S. adults: National Health Interview Survey, 2009. 2010, Hyattsville, MD: National Center for Health Statistics, Series 10, No. 249
11.
go back to reference Anand VK: Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004, 193: 3-5.PubMed Anand VK: Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004, 193: 3-5.PubMed
12.
go back to reference IMS Health: Canadian Disease and Therapeutic Index (CDTI) database. 2006 IMS Health: Canadian Disease and Therapeutic Index (CDTI) database. 2006
13.
go back to reference Gwaltney JM, Hendley JO, Patrie JT: Symptom severity patterns in experimental common colds and their usefulness in timing onset of illness in natural colds. Clin Infect Dis. 2003, 36: 714-723. 10.1086/367844.CrossRefPubMed Gwaltney JM, Hendley JO, Patrie JT: Symptom severity patterns in experimental common colds and their usefulness in timing onset of illness in natural colds. Clin Infect Dis. 2003, 36: 714-723. 10.1086/367844.CrossRefPubMed
14.
go back to reference Gwaltney JM: Rhinovirus infection of the normal human airway. Am J Respir Crit Care Med. 1995, 152: S36-39.CrossRefPubMed Gwaltney JM: Rhinovirus infection of the normal human airway. Am J Respir Crit Care Med. 1995, 152: S36-39.CrossRefPubMed
15.
go back to reference Slavin RG, Spector SL, Bernstein IL, Kaliner MA, Kennedy DW, Virant FS, Wald ER, Khan DA, Blessing-Moore J, Lang DM: The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005, 116: S13-47. 10.1016/j.jaci.2005.09.048.CrossRefPubMed Slavin RG, Spector SL, Bernstein IL, Kaliner MA, Kennedy DW, Virant FS, Wald ER, Khan DA, Blessing-Moore J, Lang DM: The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol. 2005, 116: S13-47. 10.1016/j.jaci.2005.09.048.CrossRefPubMed
16.
go back to reference Tomassen P, Newson RB, Hoffmans R, Lotvall J, Cardell LO, Gunnbjornsdottir M, Thilsing T, Matricardi P, Kramer U, Makowska JS: Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis--a GA(2) LEN study. Allergy. 2011, 66: 556-561. 10.1111/j.1398-9995.2010.02503.x.CrossRefPubMed Tomassen P, Newson RB, Hoffmans R, Lotvall J, Cardell LO, Gunnbjornsdottir M, Thilsing T, Matricardi P, Kramer U, Makowska JS: Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis--a GA(2) LEN study. Allergy. 2011, 66: 556-561. 10.1111/j.1398-9995.2010.02503.x.CrossRefPubMed
17.
go back to reference Bhattacharyya N, Lee LN: Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy. Otolaryngol Head Neck Surg. 2010, 143: 147-151. 10.1016/j.otohns.2010.04.012.CrossRefPubMed Bhattacharyya N, Lee LN: Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy. Otolaryngol Head Neck Surg. 2010, 143: 147-151. 10.1016/j.otohns.2010.04.012.CrossRefPubMed
18.
go back to reference Green K, McGreer A, Church D, Weiss K, Davidson R, Hoban D, Kibsey P, Kuhn M, Toye B, Pong-Porter S: Trends in antimicrobial resistance in Canadian strains of Streptococcus pneumoniae, 1988-2003. 43rd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy 9/14/2003. 2003, Chicago Green K, McGreer A, Church D, Weiss K, Davidson R, Hoban D, Kibsey P, Kuhn M, Toye B, Pong-Porter S: Trends in antimicrobial resistance in Canadian strains of Streptococcus pneumoniae, 1988-2003. 43rd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy 9/14/2003. 2003, Chicago
19.
go back to reference Green K, Pong-Porter S, Plevneshi A, McGeer A, Low EE, Canadian Bacterial Surveillance Network: Trends in antimicrobial prescribing and pneumococcal resistance, Canada, 1993-2005. 46th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy 9/27/2006. 2006, San Francisco Green K, Pong-Porter S, Plevneshi A, McGeer A, Low EE, Canadian Bacterial Surveillance Network: Trends in antimicrobial prescribing and pneumococcal resistance, Canada, 1993-2005. 46th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy 9/27/2006. 2006, San Francisco
20.
go back to reference Pynnonen MA, Mukerji SS, Kim HM, Adams ME, Terrell JE: Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Arch Otolaryngol Head Neck Surg. 2007, 133: 1115-1120. 10.1001/archotol.133.11.1115.CrossRefPubMed Pynnonen MA, Mukerji SS, Kim HM, Adams ME, Terrell JE: Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Arch Otolaryngol Head Neck Surg. 2007, 133: 1115-1120. 10.1001/archotol.133.11.1115.CrossRefPubMed
21.
go back to reference Harvey R, Hannan SA, Badia L, Scadding G: Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev. 2007, CD006394- Harvey R, Hannan SA, Badia L, Scadding G: Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev. 2007, CD006394-
22.
go back to reference Ottaviano G, Marioni G, Staffieri C, Giacomelli L, Marchese-Ragona R, Bertolin A, Staffieri A: Effects of sulfurous, salty, bromic, iodic thermal water nasal irrigations in nonallergic chronic rhinosinusitis: a prospective, randomized, double-blind, clinical, and cytological study. Am J Otolaryngol. 2011, 32: 235-239. 10.1016/j.amjoto.2010.02.004.CrossRefPubMed Ottaviano G, Marioni G, Staffieri C, Giacomelli L, Marchese-Ragona R, Bertolin A, Staffieri A: Effects of sulfurous, salty, bromic, iodic thermal water nasal irrigations in nonallergic chronic rhinosinusitis: a prospective, randomized, double-blind, clinical, and cytological study. Am J Otolaryngol. 2011, 32: 235-239. 10.1016/j.amjoto.2010.02.004.CrossRefPubMed
23.
go back to reference Hauptman G, Ryan MW: The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients. Otolaryngol Head Neck Surg. 2007, 137: 815-821. 10.1016/j.otohns.2007.07.034.CrossRefPubMed Hauptman G, Ryan MW: The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients. Otolaryngol Head Neck Surg. 2007, 137: 815-821. 10.1016/j.otohns.2007.07.034.CrossRefPubMed
24.
go back to reference Ural A, Oktemer TK, Kizil Y, Ileri F, Uslu S: Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study. J Laryngol Otol. 2009, 123: 517-521. 10.1017/S0022215108003964.CrossRefPubMed Ural A, Oktemer TK, Kizil Y, Ileri F, Uslu S: Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study. J Laryngol Otol. 2009, 123: 517-521. 10.1017/S0022215108003964.CrossRefPubMed
25.
go back to reference Emanuel IA, Shah SB: Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 2000, 123: 687-691. 10.1067/mhn.2000.110961.CrossRefPubMed Emanuel IA, Shah SB: Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 2000, 123: 687-691. 10.1067/mhn.2000.110961.CrossRefPubMed
26.
go back to reference Alho OP, Karttunen R, Karttunen TJ: Nasal mucosa in natural colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis. Clin Exp Immunol. 2004, 137: 366-372. 10.1111/j.1365-2249.2004.02530.x.CrossRefPubMedPubMedCentral Alho OP, Karttunen R, Karttunen TJ: Nasal mucosa in natural colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis. Clin Exp Immunol. 2004, 137: 366-372. 10.1111/j.1365-2249.2004.02530.x.CrossRefPubMedPubMedCentral
Metadata
Title
Canadian guidelines for rhinosinusitis: practical tools for the busy clinician
Author
Shaun Kilty
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Ear, Nose and Throat Disorders / Issue 1/2012
Electronic ISSN: 1472-6815
DOI
https://doi.org/10.1186/1472-6815-12-1

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