New Definitions for Chronic Rhinosinustis Issued by Experts in Treatment of Upper Respiratory Disorders

Newswise — Some 31 million Americans are believed to have sinusitis each year, a medical condition more prevalent than arthritis and hypertension and when chronic, equally debilitating as diabetes and chronic heart disease.

Otolaryngologist—head and neck surgeons who treat this upper airway disorder have called for replacing the term "sinusitis" with "rhinosinusitis" because the condition rarely occurs without concurrent nasal airway inflammation. Rhinosinusitis comprises a spectrum of inflammatory and infectious diseases concurrently affecting the nose and paranasal sinuses. Unfortunately, the accuracy of reported rhinosinusitis cases is difficult to ascertain because its diagnosis, on the basis of symptoms alone, is common but can be unreliable. Furthermore, the accuracy of prevalence estimates is also affected by the absence of uniformly accepted definitions for chronic rhinosinusitis.

The ability to do effective clinical care or develop new drug therapy has been limited by the lack of a definition that provides a template for the clinician or research investigator. This much needed clarity has been brought to defining chronic rhinosinusitis, through the efforts of a multidisciplinary task force convened by the Sinus and Allergy Health Partnership (SAHP), a collaborative initiative by the American Academy of Otolaryngic Allergy (AAOA), the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and the American Rhinologic Society (ARS).

The SAHP seeks to provide increased awareness to both the public and healthcare providers, enabling them to make better-educated decisions about the treatment of allergies and sinus disease. To that end, they have just published their new report, "Adult Chronic Rhinosinusitis: Definitions, Diagnosis, Epidemiology, and Pathophysiology," as a supplement to the September 2003 edition of Otolaryngology—Head and Neck Surgery. This major undertaking represents a needed step for all clinicians to effectively diagnose and treat this medical disorder that results in 18 to 22 million physician visits each year.

The authors of this report are otolaryngologists and AAO-HNS members Michael S. Benninger, MD, Berrylin J. Ferguson, MD, James A. Hadley, MD, Daniel L. Hamilos, MD, Michael Jacobs, MD, David W. Kennedy, MD, Donald C. Lanza, MD, Bradley F. Marple, MD, J. David Osguthorpe, MD, James A. Stankiewicz, MD, Jack Anon, MD, James Denneny, MD, Ivor Emanuel, MD, and Howard Levine, MD.

This groundbreaking study provides comprehensive and detailed insight regarding the pathophysiologic causes and the epidemiology of chronic rhinosinusitis. After a thorough review of the literature and the most current research findings, the authors state that that chronic rhinosinusitis is now defined as a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks' duration.

This basic definition facilitated a consensus, with a definition that can be used in both clinical care and research with consistency. The review of this disease provided in this report provides a consistent baseline so that further investigation can proceed to help answer many of the currently debated or unanswered questions regarding the nature of persistent sinus disorders.