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href="#Osseous_complications"> <div class="vector-toc-text"> 1.2.3 Osseous complications </div> </a> <ul id="toc-Osseous_complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Causes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Causes"> <div class="vector-toc-text"> 2 Causes </div> </a> <button aria-controls="toc-Causes-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Causes subsection </button> <ul id="toc-Causes-sublist" class="vector-toc-list"> <li id="toc-Acute" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Acute"> <div class="vector-toc-text"> 2.1 Acute </div> </a> <ul id="toc-Acute-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chronic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chronic"> <div class="vector-toc-text"> 2.2 Chronic </div> </a> <ul id="toc-Chronic-sublist" class="vector-toc-list"> <li id="toc-Definition_and_nomenclature" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Definition_and_nomenclature"> <div class="vector-toc-text"> 2.2.1 Definition and nomenclature </div> </a> <ul id="toc-Definition_and_nomenclature-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fungi" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Fungi"> <div class="vector-toc-text"> 2.2.2 Fungi </div> </a> <ul id="toc-Fungi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-One_airway_theory" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#One_airway_theory"> <div class="vector-toc-text"> 2.2.3 One airway theory </div> </a> <ul id="toc-One_airway_theory-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Smoking" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Smoking"> <div class="vector-toc-text"> 2.2.4 Smoking </div> </a> <ul id="toc-Smoking-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Air_pollution" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Air_pollution"> <div class="vector-toc-text"> 2.2.5 Air pollution </div> </a> <ul id="toc-Air_pollution-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_diseases" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Other_diseases"> <div class="vector-toc-text"> 2.2.6 Other diseases </div> </a> <ul id="toc-Other_diseases-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Maxillary_sinus" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Maxillary_sinus"> <div class="vector-toc-text"> 2.3 Maxillary sinus </div> </a> <ul id="toc-Maxillary_sinus-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> 3 Pathophysiology </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 4 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Classification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Classification"> <div class="vector-toc-text"> 4.1 Classification </div> </a> <ul id="toc-Classification-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Acute_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Acute_2"> <div class="vector-toc-text"> 4.2 Acute </div> </a> <ul id="toc-Acute_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chronic_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chronic_2"> <div class="vector-toc-text"> 4.3 Chronic </div> </a> <ul id="toc-Chronic_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> 5 Treatment </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Treatment subsection </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Antibiotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiotics"> <div class="vector-toc-text"> 5.1 Antibiotics </div> </a> <ul id="toc-Antibiotics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Corticosteroids" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Corticosteroids"> <div class="vector-toc-text"> 5.2 Corticosteroids </div> </a> <ul id="toc-Corticosteroids-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 5.3 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatments_directed_to_rhinovirus_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Treatments_directed_to_rhinovirus_infection"> <div class="vector-toc-text"> 5.4 Treatments directed to rhinovirus infection </div> </a> <ul id="toc-Treatments_directed_to_rhinovirus_infection-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 6 Prognosis </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 7 Epidemiology </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> 8 Research </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> 9 See also </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 10 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 11 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Sinusitis</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 69 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-69" aria-hidden="true" > 69 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%AA%D9%87%D8%A7%D8%A8_%D8%A7%D9%84%D8%AC%D9%8A%D9%88%D8%A8" title="التهاب الجيوب – Arabic" lang="ar" hreflang="ar" data-title="التهاب الجيوب" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D4%BD%D5%B8%D5%BC%D5%B8%D5%B9%D5%A1%D5%BF%D5%A1%D5%BA" title="Խոռոչատապ – Western Armenian" lang="hyw" hreflang="hyw" data-title="Խոռոչատապ" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target">Արեւմտահայերէն</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B8%E0%A6%BE%E0%A6%87%E0%A6%A8%E0%A7%81%E0%A6%B8%E0%A6%BE%E0%A6%87%E0%A6%9F%E0%A6%BF%E0%A6%B8" title="সাইনুসাইটিস – Bangla" lang="bn" hreflang="bn" data-title="সাইনুসাইটিস" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D1%83%D0%B8%D1%82" title="Синуит – Bulgarian" lang="bg" hreflang="bg" data-title="Синуит" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Catalan" lang="ca" hreflang="ca" data-title="Sinusitis" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Sinusitida" title="Sinusitida – Czech" lang="cs" hreflang="cs" data-title="Sinusitida" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Bihulebet%C3%A6ndelse" title="Bihulebetændelse – Danish" lang="da" hreflang="da" data-title="Bihulebetændelse" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Sinusitis" title="Sinusitis – German" lang="de" hreflang="de" data-title="Sinusitis" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%90%DE%A6%DE%87%DE%A8%DE%82%DE%A6%DE%90%DE%B0" title="ސައިނަސް – Divehi" lang="dv" hreflang="dv" data-title="ސައިނަސް" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target">ދިވެހިބަސް</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%99%CE%B3%CE%BC%CE%BF%CF%81%CE%AF%CF%84%CE%B9%CE%B4%CE%B1" title="Ιγμορίτιδα – Greek" lang="el" hreflang="el" data-title="Ιγμορίτιδα" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Rinosinusitis" title="Rinosinusitis – Spanish" lang="es" hreflang="es" data-title="Rinosinusitis" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Sinusito" title="Sinusito – Esperanto" lang="eo" hreflang="eo" data-title="Sinusito" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Basque" lang="eu" hreflang="eu" data-title="Sinusitis" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%DB%8C%D9%86%D9%88%D8%B2%DB%8C%D8%AA" title="سینوزیت – Persian" lang="fa" hreflang="fa" data-title="سینوزیت" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Sinusite" title="Sinusite – French" lang="fr" hreflang="fr" data-title="Sinusite" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Cuais%C3%ADteas" title="Cuaisíteas – Irish" lang="ga" hreflang="ga" data-title="Cuaisíteas" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target">Gaeilge</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Sinusite" title="Sinusite – Galician" lang="gl" hreflang="gl" data-title="Sinusite" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%B6%80%EB%B9%84%EB%8F%99%EC%97%BC" title="부비동염 – Korean" lang="ko" hreflang="ko" data-title="부비동염" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%8D%D5%AB%D5%B6%D5%B8%D6%82%D5%BD%D5%AB%D5%BF" title="Սինուսիտ – Armenian" lang="hy" hreflang="hy" data-title="Սինուսիտ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B8%E0%A4%BE%E0%A4%87%E0%A4%A8%E0%A5%8B%E0%A4%B8%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8" title="साइनोसाइटिस – Hindi" lang="hi" hreflang="hi" data-title="साइनोसाइटिस" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Croatian" lang="hr" hreflang="hr" data-title="Sinusitis" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Indonesian" lang="id" hreflang="id" data-title="Sinusitis" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Interlingua" lang="ia" hreflang="ia" data-title="Sinusitis" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target">Interlingua</a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Sinusite" title="Sinusite – Italian" lang="it" hreflang="it" data-title="Sinusite" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A1%D7%99%D7%A0%D7%95%D7%A1%D7%99%D7%98%D7%99%D7%A1" title="סינוסיטיס – Hebrew" lang="he" hreflang="he" data-title="סינוסיטיס" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Javanese" lang="jv" hreflang="jv" data-title="Sinusitis" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target">Jawa</a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%B0%E1%83%90%E1%83%98%E1%83%9B%E1%83%9D%E1%83%A0%E1%83%98%E1%83%A2%E1%83%98" title="ჰაიმორიტი – Georgian" lang="ka" hreflang="ka" data-title="ჰაიმორიტი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target">ქართული</a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D1%83%D1%81%D0%B8%D1%82" title="Синусит – Kazakh" lang="kk" hreflang="kk" data-title="Синусит" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target">Қазақша</a></li><li class="interlanguage-link interwiki-rw mw-list-item"><a href="https://rw.wikipedia.org/wiki/Sinizite" title="Sinizite – Kinyarwanda" lang="rw" hreflang="rw" data-title="Sinizite" data-language-autonym="Ikinyarwanda" data-language-local-name="Kinyarwanda" class="interlanguage-link-target">Ikinyarwanda</a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/S%C3%AEn%C3%BBz%C3%AEt" title="Sînûzît – Kurdish" lang="ku" hreflang="ku" data-title="Sînûzît" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target">Kurdî</a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%93%D0%B0%D0%B9%D0%BC%D0%BE%D1%80%D0%B8%D1%82" title="Гайморит – Kyrgyz" lang="ky" hreflang="ky" data-title="Гайморит" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target">Кыргызча</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Deguna_blakusdobumu_iekaisums" title="Deguna blakusdobumu iekaisums – Latvian" lang="lv" hreflang="lv" data-title="Deguna blakusdobumu iekaisums" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Haimoritas" title="Haimoritas – Lithuanian" lang="lt" hreflang="lt" data-title="Haimoritas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-ln mw-list-item"><a href="https://ln.wikipedia.org/wiki/Sinusite" title="Sinusite – Lingala" lang="ln" hreflang="ln" data-title="Sinusite" data-language-autonym="Lingála" data-language-local-name="Lingala" class="interlanguage-link-target">Lingála</a></li><li class="interlanguage-link interwiki-lg mw-list-item"><a href="https://lg.wikipedia.org/wiki/Obulwadde_bw%E2%80%99ekiwanga" title="Obulwadde bw’ekiwanga – Ganda" lang="lg" hreflang="lg" data-title="Obulwadde bw’ekiwanga" data-language-autonym="Luganda" data-language-local-name="Ganda" class="interlanguage-link-target">Luganda</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Arc%C3%BCreggyullad%C3%A1s" title="Arcüreggyulladás – Hungarian" lang="hu" hreflang="hu" data-title="Arcüreggyulladás" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%AA%E0%B5%80%E0%B4%A8%E0%B4%B8%E0%B4%82" title="പീനസം – Malayalam" lang="ml" hreflang="ml" data-title="പീനസം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Resdung" title="Resdung – Malay" lang="ms" hreflang="ms" data-title="Resdung" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Bijholteontsteking" title="Bijholteontsteking – Dutch" lang="nl" hreflang="nl" data-title="Bijholteontsteking" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%AA%E0%A4%BF%E0%A4%A8%E0%A4%BE%E0%A4%B8" title="पिनास – Nepali" lang="ne" hreflang="ne" data-title="पिनास" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target">नेपाली</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%89%AF%E9%BC%BB%E8%85%94%E7%82%8E" title="副鼻腔炎 – Japanese" lang="ja" hreflang="ja" data-title="副鼻腔炎" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Bihulebetennelse" title="Bihulebetennelse – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Bihulebetennelse" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Biholebetennelse" title="Biholebetennelse – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Biholebetennelse" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target">Norsk nynorsk</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B8%E0%AC%BE%E0%AC%87%E0%AC%A8%E0%AD%81%E0%AC%B8%E0%AC%BE%E0%AC%87%E0%AC%9F%E0%AC%BF%E0%AC%B8" title="ସାଇନୁସାଇଟିସ – Odia" lang="or" hreflang="or" data-title="ସାଇନୁସାଇଟିସ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%B3%D9%8A%D9%86%D9%88%D8%B3%D8%A7%D9%8A%D9%BC%D8%B3" title="سينوسايټس – Pashto" lang="ps" hreflang="ps" data-title="سينوسايټس" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target">پښتو</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zapalenie_zatok_przynosowych" title="Zapalenie zatok przynosowych – Polish" lang="pl" hreflang="pl" data-title="Zapalenie zatok przynosowych" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Sinusite" title="Sinusite – Portuguese" lang="pt" hreflang="pt" data-title="Sinusite" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Sinuzit%C4%83" title="Sinuzită – Romanian" lang="ro" hreflang="ro" data-title="Sinuzită" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D1%83%D1%81%D0%B8%D1%82" title="Синусит – Russian" lang="ru" hreflang="ru" data-title="Синусит" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D1%83%D1%81%D0%B8%D1%82%D0%BA%D0%B0" title="Синуситка – Yakut" lang="sah" hreflang="sah" data-title="Синуситка" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target">Саха тыла</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Sinuziti" title="Sinuziti – Albanian" lang="sq" hreflang="sq" data-title="Sinuziti" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%9A%E0%B7%9D%E0%B6%A8%E0%B6%BB%E0%B6%9A_%E0%B6%B4%E0%B7%8A%E2%80%8D%E0%B6%BB%E0%B6%AF%E0%B7%8F%E0%B7%84%E0%B6%BA" title="කෝඨරක ප්‍රදාහය – Sinhala" lang="si" hreflang="si" data-title="කෝඨරක ප්‍රදාහය" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Simple English" lang="en-simple" hreflang="en-simple" data-title="Sinusitis" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Vnetje_sinusov" title="Vnetje sinusov – Slovenian" lang="sl" hreflang="sl" data-title="Vnetje sinusov" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%B3%DB%8C%D9%86%D9%88%D9%88%D8%B2%DB%8C%D8%AA" title="سینووزیت – Central Kurdish" lang="ckb" hreflang="ckb" data-title="سینووزیت" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target">کوردی</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A3%D0%BF%D0%B0%D0%BB%D0%B0_%D1%81%D0%B8%D0%BD%D1%83%D1%81%D0%B0" title="Упала синуса – Serbian" lang="sr" hreflang="sr" data-title="Упала синуса" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Sinusitis" title="Sinusitis – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Sinusitis" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target">Srpskohrvatski / српскохрватски</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Poskiontelontulehdus" title="Poskiontelontulehdus – Finnish" lang="fi" hreflang="fi" data-title="Poskiontelontulehdus" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Bih%C3%A5leinflammation" title="Bihåleinflammation – Swedish" lang="sv" hreflang="sv" data-title="Bihåleinflammation" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AA%E0%AF%81%E0%AE%B0%E0%AF%88%E0%AE%AF%E0%AE%B4%E0%AE%B1%E0%AF%8D%E0%AE%9A%E0%AE%BF" title="புரையழற்சி – Tamil" lang="ta" hreflang="ta" data-title="புரையழற்சி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target">தமிழ்</a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%93%D0%B0%D0%B9%D0%BC%D0%BE%D1%80%D0%B8%D1%82" title="Гайморит – Tatar" lang="tt" hreflang="tt" data-title="Гайморит" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target">Татарча / tatarça</a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%B8%E0%B1%88%E0%B0%A8%E0%B0%B8%E0%B1%88%E0%B0%9F%E0%B0%BF%E0%B0%B8%E0%B1%8D" title="సైనసైటిస్ – Telugu" lang="te" hreflang="te" data-title="సైనసైటిస్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target">తెలుగు</a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%9E%E0%B8%A3%E0%B8%87%E0%B8%AD%E0%B8%B2%E0%B8%81%E0%B8%B2%E0%B8%A8%E0%B8%AD%E0%B8%B1%E0%B8%81%E0%B9%80%E0%B8%AA%E0%B8%9A" title="โพรงอากาศอักเสบ – Thai" lang="th" hreflang="th" data-title="โพรงอากาศอักเสบ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target">ไทย</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Sin%C3%BCzit" title="Sinüzit – Turkish" lang="tr" hreflang="tr" data-title="Sinüzit" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A1%D0%B8%D0%BD%D1%83%D1%81%D0%B8%D1%82" title="Синусит – Ukrainian" lang="uk" hreflang="uk" data-title="Синусит" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target">Українська</a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Vi%C3%AAm_xoang" title="Viêm xoang – Vietnamese" lang="vi" hreflang="vi" data-title="Viêm xoang" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target">Tiếng Việt</a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E9%BC%BB%E7%AA%A6%E7%82%8E" title="鼻窦炎 – Wu" lang="wuu" hreflang="wuu" data-title="鼻窦炎" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target">吴语</a></li><li 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class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Inflammation of the inner lining of the sinuses</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For the joint inflammation condition, see <a href="/wiki/Synovitis" title="Synovitis">Synovitis</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Sinusitis</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Sinus infection, rhinosinusitis</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Sinusitis_cdc.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/85/Sinusitis_cdc.png/220px-Sinusitis_cdc.png" decoding="async" width="220" height="144" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/85/Sinusitis_cdc.png/330px-Sinusitis_cdc.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/85/Sinusitis_cdc.png/440px-Sinusitis_cdc.png 2x" data-file-width="1101" data-file-height="720" /></a></td></tr><tr><td colspan="2" class="infobox-full-data">An illustration showing the difference between healthy sinuses and diseased sinuses</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Otorhinolaryngology" title="Otorhinolaryngology">Otorhinolaryngology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Nasal_discharge" class="mw-redirect" title="Nasal discharge">nasal discharge</a>, <a href="/wiki/Nasal_blockage" class="mw-redirect" title="Nasal blockage">nasal blockage</a>, <a href="/wiki/Facial_pain" class="mw-redirect" title="Facial pain">facial pain</a>, reduction or loss of smell, <a href="/wiki/Fever" title="Fever">fever</a><a href="#cite_note-pmid25833927-1">[1]</a><a href="#cite_note-pmid27113482-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><a href="/wiki/Infection" title="Infection">Infection</a> (bacterial, fungal, viral), <a href="/wiki/Allergy" title="Allergy">allergies</a>, <a href="/wiki/Air_pollution" title="Air pollution">air pollution</a>, structural problems in the nose<a href="#cite_note-cdc.gov-20132-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Asthma" title="Asthma">Asthma</a>, <a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">cystic fibrosis</a>, <a href="/wiki/Immunodeficiency" title="Immunodeficiency">poor immune function</a><a href="#cite_note-pmid25833927-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Usually based on symptoms</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Common_cold" title="Common cold">common cold</a>, <a href="/wiki/Rhinitis" title="Rhinitis">rhinitis</a>, <a href="/wiki/Upper_respiratory_infection" class="mw-redirect" title="Upper respiratory infection">upper respiratory infection</a>, <a href="/wiki/Temporomandibular_joint_disorder" class="mw-redirect" title="Temporomandibular joint disorder">temporomandibular joint disorder</a>, <a href="/wiki/Tension_headache" title="Tension headache">tension headache</a>, <a href="/wiki/Vascular_headache" title="Vascular headache">vascular headache</a>, <a href="/wiki/Dental_infection" class="mw-redirect" title="Dental infection">dental infection</a></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">handwashing, vaccinations, avoiding smoking<a href="#cite_note-cdc.gov-20132-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Analgesics" class="mw-redirect" title="Analgesics">Pain medications</a>, <a href="/wiki/Nasal_steroid" class="mw-redirect" title="Nasal steroid">nasal steroids</a>, <a href="/wiki/Nasal_irrigation" title="Nasal irrigation">nasal irrigation</a>, <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a><a href="#cite_note-pmid25833927-1">[1]</a><a href="#cite_note-pmid25892369-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">10–30% each year (developed world)<a href="#cite_note-pmid25833927-1">[1]</a><a href="#cite_note-Adkinson-2014-5">[5]</a></td></tr></tbody></table> Sinusitis, also known as rhinosinusitis, is an <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> of the <a href="/wiki/Nasal_mucosa" title="Nasal mucosa">mucous membranes</a> that line the <a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinuses</a> resulting in symptoms that may include production of thick <a href="/wiki/Mucus#Respiratory_system" title="Mucus">nasal mucus</a>, <a href="/wiki/Nasal_congestion" title="Nasal congestion">nasal congestion</a>, facial congestion, <a href="/wiki/Orofacial_pain" title="Orofacial pain">facial pain</a>, facial pressure, <a href="/wiki/Hyposmia" title="Hyposmia">loss of smell</a>, or <a href="/wiki/Fever" title="Fever">fever</a>.<a href="#cite_note-pmid258339273-6">[6]</a><a href="#cite_note-7">[7]</a> Sinusitis is a condition that affects both children and adults. It is caused by a combination of environmental and a person's individual health factors.<a href="#cite_note-8">[8]</a> It can occur in individuals with <a href="/wiki/Allergy" title="Allergy">allergies</a>, exposure to environmental irritants, structural abnormalities of the <a href="/wiki/Nasal_cavity" title="Nasal cavity">nasal cavity</a> and <a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinuses</a> and <a href="/wiki/Immunodeficiency" title="Immunodeficiency">poor immune function</a>.<a href="#cite_note-Adkinson-20143-9">[9]</a> Most cases are caused by a <a href="/wiki/Viral_infection" class="mw-redirect" title="Viral infection">viral infection</a>.<a href="#cite_note-cdc.gov-20132-3">[3]</a> Recurrent episodes are more likely in persons with <a href="/wiki/Asthma" title="Asthma">asthma</a>, <a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">cystic fibrosis</a>, and <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immunodeficiency</a>.<a href="#cite_note-pmid258339275-10">[10]</a> The diagnosis of sinusitis is based on the symptoms and their duration along with signs of disease identified by <a href="/wiki/Endoscopy" title="Endoscopy">endoscopic</a> and/or <a href="/wiki/Radiology" title="Radiology">radiologic</a> criteria.<a href="#cite_note-Adkinson-20142-11">[11]</a> Sinusitis is classified into acute sinusitis and chronic sinusitis. In acute sinusitis, symptoms last for less than 4 weeks. In chronic sinusitis symptoms must be present for at least 12 weeks.<a href="#cite_note-12">[12]</a> In the initial evaluation of sinusitis an <a href="/wiki/Otolaryngologist" class="mw-redirect" title="Otolaryngologist">Otolaryngologist</a>, also known as an <a href="/wiki/Ear,_Nose_and_Throat" class="mw-redirect" title="Ear, Nose and Throat">ear, nose and throat</a> (ENT) doctor, may confirm sinusitis using <a href="/wiki/Endoscopy" title="Endoscopy">nasal endoscopy</a>.<a href="#cite_note-Adkinson-20142-11">[11]</a> Diagnostic imaging is not usually needed in acute stage unless complications are suspected.<a href="#cite_note-pmid258339274-13">[13]</a> In chronic cases, confirmatory testing is recommended by use of <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">computed tomography</a>.<a href="#cite_note-pmid258339274-13">[13]</a> Prevention of sinusitis focuses on regular hand washing, staying up-to date on <a href="/wiki/Vaccination" title="Vaccination">vaccinations</a>, and avoiding <a href="/wiki/Smoking" title="Smoking">smoking</a>.<a href="#cite_note-cdc.gov-20133-14">[14]</a> <a href="/wiki/Analgesics" class="mw-redirect" title="Analgesics">Pain killers</a> such as <a href="/wiki/Naproxen" title="Naproxen">naproxen</a>, <a href="/wiki/Nasal_steroid" class="mw-redirect" title="Nasal steroid">nasal steroids</a>, and <a href="/wiki/Nasal_irrigation" title="Nasal irrigation">nasal irrigation</a> may be used to help with symptoms.<a href="#cite_note-pmid258339276-15">[15]</a><a href="#cite_note-pmid258923692-16">[16]</a> Recommended initial treatment for acute sinusitis is <a href="/wiki/Watchful_waiting" title="Watchful waiting">watchful waiting</a>.<a href="#cite_note-pmid258339276-15">[15]</a> If symptoms do not improve in 7–10 days or worsen, then an <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a> may be implemented or changed.<a href="#cite_note-pmid258339276-15">[15]</a> In those in whom antibiotics are indicated, either <a href="/wiki/Amoxicillin" title="Amoxicillin">amoxicillin</a> or <a href="/wiki/Amoxicillin/clavulanate" class="mw-redirect" title="Amoxicillin/clavulanate">amoxicillin/clavulanate</a> is recommended first line, with <a href="/wiki/Amoxicillin/clavulanate" class="mw-redirect" title="Amoxicillin/clavulanate">amoxicillin/clavulanate</a> being superior to <a href="/wiki/Amoxicillin" title="Amoxicillin">amoxicillin</a> alone but with more side effects.<a href="#cite_note-pmid332365252-17">[17]</a><a href="#cite_note-pmid258339276-15">[15]</a> Surgery may be recommended in those with chronic disease who have failed medical management.<a href="#cite_note-18">[18]</a> Sinusitis is a common condition.<a href="#cite_note-pmid258339272-19">[19]</a> It affects between about 10 and 30 percent of people each year in the United States and Europe.<a href="#cite_note-pmid258339272-19">[19]</a><a href="#cite_note-Adkinson-2014-5">[5]</a> The management of sinusitis in the United States results in more than US$11 billion in costs.<a href="#cite_note-pmid258339272-19">[19]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=1" title="Edit section: Signs and symptoms">edit</a>]</div> Acute sinusitis can present as facial pain and tenderness that may worsen with staining or bending over, headache, cough, bad breath, nasal congestion, ear pain, ear pressure or <a href="/wiki/Rhinorrhea" title="Rhinorrhea">nasal discharge</a> that is usually green in color, and may contain <a href="/wiki/Pus" title="Pus">pus</a> or blood.<a href="#cite_note-20">[20]</a> Dental pain can also occur. A way to distinguish between toothache and sinusitis is that sinusitis-related pain is usually worsened by tilting the head forward or performing the <a href="/wiki/Valsalva_maneuver" title="Valsalva maneuver">Valsalva maneuver</a>.<a href="#cite_note-pmid24861778-21">[21]</a> Chronic sinusitis presents with more subtle symptoms of nasal obstruction, with less fever and pain complaints. <a href="#cite_note-22">[22]</a> Symptoms include facial pain, <a href="/wiki/Headache" title="Headache">headache</a>, night-time coughing, an increase in previously minor or controlled asthma symptoms, general <a href="/wiki/Malaise" title="Malaise">malaise</a>, thick green or yellow nasal <a href="/wiki/Rhinorrhea" title="Rhinorrhea">discharge</a>, feeling of facial fullness or tightness that may worsen when bending over, dizziness, aching teeth, and <a href="/wiki/Halitosis" class="mw-redirect" title="Halitosis">bad breath</a>.<a href="#cite_note-Radojicic2-23">[23]</a> Often, chronic sinusitis can lead to <a href="/wiki/Anosmia" title="Anosmia">anosmia</a>, the loss of the sense of <a href="/wiki/Olfaction" class="mw-redirect" title="Olfaction">smell</a>.<a href="#cite_note-Radojicic2-23">[23]</a> A 2005 review suggested that most "sinus headaches" are migraines.<a href="#cite_note-24">[24]</a> The confusion occurs in part because migraine involves activation of the <a href="/wiki/Trigeminal_nerves" class="mw-redirect" title="Trigeminal nerves">trigeminal nerves</a>, which innervate both the sinus region and the <a href="/wiki/Meninges" title="Meninges">meninges</a> surrounding the brain. As a result, accurately determining the site from which the pain originates is difficult. People with migraines do not typically have the thick nasal discharge that is a common symptom of a sinus infection.<a href="#cite_note-25">[25]</a> <div class="mw-heading mw-heading3"><h3 id="By_location">By location</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=2" title="Edit section: By location">edit</a>]</div> The four paired <a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">paranasal sinuses</a> are the frontal, ethmoidal, maxillary, and sphenoidal sinuses. The <a href="/wiki/Ethmoid_sinus" title="Ethmoid sinus">ethmoidal sinuses</a> are further subdivided into anterior and posterior ethmoid sinuses, the division of which is defined as the <a href="/wiki/Ethmoid_sinus#Groups_of_sinuses" title="Ethmoid sinus">basal lamella</a> of the <a href="/wiki/Middle_nasal_concha" title="Middle nasal concha">middle nasal concha</a>. In addition to the severity of <a href="/wiki/Disease" title="Disease">disease</a>, discussed below, sinusitis can be classified by the sinus cavity it affects: <ul><li><a href="/wiki/Maxillary_sinus" title="Maxillary sinus">Maxillary</a> – may cause pain or pressure in the maxillary (cheek) region, often experienced as toothache or headache.<a href="#cite_note-pmid248617783-26">[26]</a></li> <li><a href="/wiki/Frontal_sinus" title="Frontal sinus">Frontal</a> – may cause pain or pressure in the frontal sinus cavity (above the eyes), often experienced as headache, particularly in the forehead area.</li> <li><a href="/wiki/Ethmoid_sinus" title="Ethmoid sinus">Ethmoidal</a> – may cause pain or pressure pain between or behind the eyes, along the sides of the upper nose (<a href="/wiki/Canthus" title="Canthus">medial canthi</a>), and headaches.<a href="#cite_note-Terézhalmy-20093-27">[27]</a></li> <li><a href="/wiki/Sphenoid_sinus" title="Sphenoid sinus">Sphenoidal</a> – may cause pain or pressure behind the eyes, though it is often felt at <a href="/wiki/Vertex_(anatomy)" title="Vertex (anatomy)">top of the head</a>, over the <a href="/wiki/Mastoid_process" class="mw-redirect" title="Mastoid process">mastoid processes</a>, or the back of the head.<a href="#cite_note-Terézhalmy-20093-27">[27]</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="Complications">Complications</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=3" title="Edit section: Complications">edit</a>]</div> <table class="wikitable" style="float: right; margin-left:15px; text-align:center"> <caption>Chandler Classification </caption> <tbody><tr> <th scope="col">Stage </th> <th scope="col">Description </th></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">I </th> <td>Preseptal cellulitis </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">II </th> <td>Orbital cellulitis </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">III </th> <td>Subperiosteal abscess </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">IV </th> <td>Orbital abscess </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">V </th> <td>Cavernous sinus septic thrombosis </td></tr></tbody></table> Complications are thought to be rare (1 case per 10,000).<a href="#cite_note-pmid18206715-28">[28]</a> Infectious complications of acute bacterial sinusitis include <a href="/wiki/Orbit_(anatomy)" title="Orbit (anatomy)">eye</a>, <a href="/wiki/Cranial_cavity" title="Cranial cavity">brain</a> and <a href="/wiki/Osseous" class="mw-redirect" title="Osseous">bone</a> complications. <a href="#cite_note-:0-29">[29]</a> <div class="mw-heading mw-heading4"><h4 id="Orbital_complications">Orbital complications</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=4" title="Edit section: Orbital complications">edit</a>]</div> The Chandler Classification is used to group orbital complications into five stages according to their severity.<a href="#cite_note-30">[30]</a> Stage I, known as preseptal cellulitis, occurs when an infection develops in front to the <a href="/wiki/Orbital_septum" title="Orbital septum">orbital septum</a>.<a href="#cite_note-:1-31">[31]</a> It is thought to result from restricted <a href="/wiki/Venous" class="mw-redirect" title="Venous">venous drainage</a> from the sinuses and affects the soft tissue of the eyelids and other superficial structures.<a href="#cite_note-:1-31">[31]</a> Stage II, known as orbital cellulitis, occurs when infection develops behind the orbital septum and affects the <a href="/wiki/Orbit_(anatomy)" title="Orbit (anatomy)">orbits</a>. <a href="#cite_note-:1-31">[31]</a> This can result in <a href="/wiki/Ophthalmoparesis" title="Ophthalmoparesis">impaired eye movement</a>, <a href="/wiki/Exophthalmos" title="Exophthalmos">protrusion of the eye</a>, and <a href="/wiki/Chemosis" title="Chemosis">eye swelling</a>. <a href="#cite_note-:1-31">[31]</a> Stage III, known as subperiosteal abscess, occurs when <a href="/wiki/Pus" title="Pus">pus</a> collects between walls of the orbit and the surrounding periosteal structures. <a href="#cite_note-:1-31">[31]</a> This can result in impaired eye movement and acuity. <a href="#cite_note-:1-31">[31]</a> Stage IV, known as orbital abscess, occurs when an abscess forms within the orbital tissue. <a href="#cite_note-:1-31">[31]</a> This can result in severe vision impairment. <a href="#cite_note-:1-31">[31]</a> Stage V, known as cavernous sinus thrombosis, is considered an intracranial complication. It can occur as bacterial spread progresses, triggering blood clots that become trapped within the cavernous sinus.<a href="#cite_note-32">[32]</a> This can result in previously described symptoms within the opposite eye and in severe cases, meningitis.<a href="#cite_note-:1-31">[31]</a> <div class="mw-heading mw-heading4"><h4 id="Intracranial_complications">Intracranial complications</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=5" title="Edit section: Intracranial complications">edit</a>]</div> The close proximity of the sinuses to the brain makes brain infections one of the most dangerous complication of acute bacterial sinusitis, especially when the frontal and sphenoid sinuses are involved. These infections can result from invasion of <a href="/wiki/Anaerobic_organisms" class="mw-redirect" title="Anaerobic organisms">anaerobic bacteria</a> through the bones or blood vessels. <a href="/wiki/Abscesses" class="mw-redirect" title="Abscesses">Abscesses</a>, <a href="/wiki/Meningitis" title="Meningitis">meningitis</a>, and other life-threatening conditions may occur. In rare cases, mild personality changes, headache, altered consciousness, visual problems, seizures, <a href="/wiki/Coma" title="Coma">coma</a>, and even death may occur.<a href="#cite_note-Patient_Education2-33">[33]</a> <div class="mw-heading mw-heading4"><h4 id="Osseous_complications">Osseous complications</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=6" title="Edit section: Osseous complications">edit</a>]</div> A rare complication of acute sinusitis is a bone infection, known as <a href="/wiki/Osteomyelitis" title="Osteomyelitis">osteomyelitis</a>, which affects the <a href="/wiki/Frontal_bone" title="Frontal bone">frontal</a> and other <a href="/wiki/Facial_skeleton" title="Facial skeleton">facial bones</a>.<a href="#cite_note-:02-34">[34]</a> Specifically, the combination of frontal sinusitis, osteomyelitis and subperiosteal abscess formation is referred to as <a href="/wiki/Pott%27s_puffy_tumor" title="Pott's puffy tumor">Pott's puffy tumor</a>.<a href="#cite_note-Patient_Education3-35">[35]</a><a href="#cite_note-:02-34">[34]</a> Other complications When an infection originating from a tooth or dental procedure affects the maxillary sinus it can lead to <a href="/wiki/Odontogenic_sinusitis" title="Odontogenic sinusitis">odontogenic sinusitis</a> (ODS).<a href="#cite_note-36">[36]</a> Odontogenic sinusitis can often spread to nearby sinuses including the ethmoid, frontal, sphenoid sinuses, and the contralateral nasal cavity.<a href="#cite_note-37">[37]</a> In rare instances, these infections may spread to the <a href="/wiki/Orbit_(anatomy)" title="Orbit (anatomy)">orbit</a>, leading to orbital <a href="/wiki/Cellulitis" title="Cellulitis">cellulitis</a>. <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=7" title="Edit section: Causes">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Acute">Acute</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=8" title="Edit section: Acute">edit</a>]</div> <a href="/wiki/Acute_(medical)" class="mw-redirect" title="Acute (medical)">Acute</a> sinusitis is usually precipitated by an earlier <a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">upper respiratory tract infection</a>, generally of <a href="/wiki/Virus" title="Virus">viral</a> origin, mostly caused by <a href="/wiki/Rhinovirus" title="Rhinovirus">rhinoviruses</a> (with RVA and RVC giving more severe infection than RVB), <a href="/wiki/Coronavirus" title="Coronavirus">coronaviruses</a>, and <a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">influenza viruses</a>, others caused by <a href="/wiki/Adenoviridae" title="Adenoviridae">adenoviruses</a>, <a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">human parainfluenza viruses</a>, <a href="/wiki/Human_respiratory_syncytial_virus" class="mw-redirect" title="Human respiratory syncytial virus">human respiratory syncytial virus</a>, <a href="/wiki/Enterovirus" title="Enterovirus">enteroviruses</a> other than rhinoviruses, and <a href="/wiki/Metapneumovirus" title="Metapneumovirus">metapneumovirus</a>. If the infection is of bacterial origin, the most common three causative agents are <a href="/wiki/Streptococcus_pneumoniae" title="Streptococcus pneumoniae">Streptococcus pneumoniae</a> (38%), <a href="/wiki/Haemophilus_influenzae" title="Haemophilus influenzae">Haemophilus influenzae</a> (36%), and <a href="/wiki/Moraxella_catarrhalis" title="Moraxella catarrhalis">Moraxella catarrhalis</a> (16%).<a href="#cite_note-pmid31613481-38">[38]</a><a href="#cite_note-pmid31430424-39">[39]</a> Until recently, H. influenzae was the most common bacterial agent to cause sinus infections. However, introduction of the H. influenzae type B (Hib) vaccine has dramatically decreased these infections and now non-typable H. influenzae (NTHI) is predominantly seen in clinics. Other sinusitis-causing <a href="/wiki/Bacterial" class="mw-redirect" title="Bacterial">bacterial</a> <a href="/wiki/Pathogen" title="Pathogen">pathogens</a> include <a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">S. aureus</a> and other <a href="/wiki/Streptococci" class="mw-redirect" title="Streptococci">streptococci</a> <a href="/wiki/Species" title="Species">species</a>, <a href="/wiki/Anaerobic_organism" title="Anaerobic organism">anaerobic bacteria</a> and, less commonly, <a href="/wiki/Gram-negative" class="mw-redirect" title="Gram-negative">Gram-negative</a> bacteria. Viral sinusitis typically lasts for 7 to 10 days.<a href="#cite_note-pmid18206715-28">[28]</a> <a href="/wiki/Acute_(medical)" class="mw-redirect" title="Acute (medical)">Acute</a> episodes of sinusitis can also result from <a href="/wiki/Fungus" title="Fungus">fungal</a> invasion. These infections are typically seen in people with <a href="/wiki/Diabetes" title="Diabetes">diabetes</a> or other <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immune deficiencies</a> (such as <a href="/wiki/AIDS" class="mw-redirect" title="AIDS">AIDS</a> or <a href="/wiki/Organ_transplant" class="mw-redirect" title="Organ transplant">transplant</a> on immunosuppressive antirejection medications) and can be life-threatening. In type I diabetics, ketoacidosis can be associated with sinusitis due to <a href="/wiki/Mucormycosis" title="Mucormycosis">mucormycosis</a>.<a href="#cite_note-40">[40]</a> <div class="mw-heading mw-heading3"><h3 id="Chronic">Chronic</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=9" title="Edit section: Chronic">edit</a>]</div> <div class="mw-heading mw-heading4"><h4 id="Definition_and_nomenclature">Definition and nomenclature</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=10" title="Edit section: Definition and nomenclature">edit</a>]</div> By definition, chronic sinusitis lasts longer than 12 weeks and can be caused by many different diseases that share chronic inflammation of the sinuses as a common symptom. It is subdivided into cases with and without <a href="/wiki/Nasal_polyp" title="Nasal polyp">polyps</a>. When polyps are present, the condition is called chronic <a href="/wiki/Hyperplastic" class="mw-redirect" title="Hyperplastic">hyperplastic</a> sinusitis; however, the causes are poorly understood.<a href="#cite_note-pmid18206715-28">[28]</a> It may develop with anatomic derangements, including deviation of the nasal septum and the presence of concha bullosa (pneumatization of the middle concha) that inhibit the outflow of mucus, or with allergic rhinitis, asthma, cystic fibrosis, and dental infections.<a href="#cite_note-41">[41]</a> Chronic rhinosinusitis represents a multifactorial inflammatory disorder, rather than simply a persistent bacterial infection.<a href="#cite_note-pmid18206715-28">[28]</a> The medical management of chronic rhinosinusitis is now focused upon controlling the inflammation that predisposes people to obstruction, reducing the incidence of infections.<a href="#cite_note-pmid21735433-42">[42]</a> Surgery may be needed if medications are not working.<a href="#cite_note-pmid21735433-42">[42]</a> Attempts have been made to provide a more consistent nomenclature for subtypes of chronic sinusitis. The presence of <a href="/wiki/Eosinophil_granulocyte" class="mw-redirect" title="Eosinophil granulocyte">eosinophils</a> in the mucous lining of the nose and paranasal sinuses has been demonstrated for many people, and this has been termed eosinophilic mucin rhinosinusitis (EMRS). Cases of EMRS may be related to an allergic response, but allergy is not often documented, resulting in further subcategorization into allergic and nonallergic EMRS.<a href="#cite_note-43">[43]</a> <div class="mw-heading mw-heading4"><h4 id="Fungi">Fungi</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=11" title="Edit section: Fungi">edit</a>]</div> A more recent, and still debated, development in chronic sinusitis is the role that <a href="/wiki/Fungi" class="mw-redirect" title="Fungi">fungi</a> play in this disease.<a href="#cite_note-44">[44]</a> Whether fungi are a definite factor in the development of chronic sinusitis remains unclear, and if they are, what is the difference between those who develop the disease and those who remain free of symptoms. Trials of antifungal treatments have had mixed results.<a href="#cite_note-45">[45]</a> <div class="mw-heading mw-heading4"><h4 id="One_airway_theory">One airway theory</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=12" title="Edit section: One airway theory">edit</a>]</div> Recent theories of sinusitis indicate that it often occurs as part of a spectrum of diseases that affect the <a href="/wiki/Respiratory_tract" title="Respiratory tract">respiratory tract</a> (i.e., the "one airway" theory) and is often linked to <a href="/wiki/Asthma" title="Asthma">asthma</a>.<a href="#cite_note-46">[46]</a><a href="#cite_note-47">[47]</a> <div class="mw-heading mw-heading4"><h4 id="Smoking">Smoking</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=13" title="Edit section: Smoking">edit</a>]</div> Both smoking and <a href="/wiki/Secondhand_smoke" class="mw-redirect" title="Secondhand smoke">secondhand smoke</a> are associated with chronic rhinosinusitis.<a href="#cite_note-pmid21890184-48">[48]</a> <div class="mw-heading mw-heading4"><h4 id="Air_pollution">Air pollution</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=14" title="Edit section: Air pollution">edit</a>]</div> Exposure to fine particulate matter (PM2.5), which consists of particles less than 2.5 micrometers in diameter, has been associated with an increased risk of developing rhinosinusitis.<a href="#cite_note-Kim2015-49">[49]</a><a href="#cite_note-Hwang2020-50">[50]</a> PM2.5 particles can penetrate deep into the respiratory tract, reaching the nasal and sinus mucosa, leading to inflammation and impaired mucociliary clearance.<a href="#cite_note-Reh2012-51">[51]</a> Individuals living in areas with higher concentrations of PM2.5 experience increased symptoms and exacerbations of chronic rhinosinusitis.<a href="#cite_note-Zhang2014-52">[52]</a> The fine particles cause oxidative stress and inflammation, contributing to the pathogenesis of rhinosinusitis.<a href="#cite_note-Harvey2015-53">[53]</a> While both PM10 (particles less than 10 micrometers) and PM2.5 can affect the respiratory system, PM2.5 particles are more closely associated with rhinosinusitis due to their ability to reach deeper into the sinus cavities.<a href="#cite_note-Maniscalco2015-54">[54]</a> These smaller particles bypass the nasal hair filtering mechanism and deposit in the mucous membranes of the sinuses, leading to greater inflammatory responses.<a href="#cite_note-D'Amato2018-55">[55]</a> The World Health Organization (WHO) recommends that annual mean concentrations of PM2.5 should not exceed 5 µg/m³, and 24-hour mean exposures should not exceed 15 µg/m³ to minimize health risks.<a href="#cite_note-WHO2021-56">[56]</a> Exposure to concentrations above these thresholds has been linked to an increased incidence and severity of rhinosinusitis and other respiratory diseases.<a href="#cite_note-Peden2020-57">[57]</a> <div class="mw-heading mw-heading4"><h4 id="Other_diseases">Other diseases</h4>[<a href="/w/index.php?title=Sinusitis&action=edit&section=15" title="Edit section: Other diseases">edit</a>]</div> Other diseases such as <a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">cystic fibrosis</a> and <a href="/wiki/Granulomatosis_with_polyangiitis" title="Granulomatosis with polyangiitis">granulomatosis with polyangiitis</a> can also cause chronic sinusitis.<a href="#cite_note-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Maxillary_sinus">Maxillary sinus</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=16" title="Edit section: Maxillary sinus">edit</a>]</div> <a href="/wiki/Maxillary_sinus" title="Maxillary sinus">Maxillary</a> sinusitis may also develop from problems with the teeth, and these cases were calculated to be about 40% in one study and 50% in another.<a href="#cite_note-American_Association_of_Endodontists-2018-59">[59]</a> The cause of this situation is usually a <a href="/wiki/Periapical" class="mw-redirect" title="Periapical">periapical</a> or <a href="/wiki/Periodontal" class="mw-redirect" title="Periodontal">periodontal</a> infection of a maxillary <a href="/wiki/Posterior_(anatomy)" class="mw-redirect" title="Posterior (anatomy)">posterior</a> tooth, where the inflammatory <a href="/wiki/Exudate" title="Exudate">exudate</a> has eroded through the bone superiorly to drain into the maxillary sinus.<a href="#cite_note-American_Association_of_Endodontists-2018-59">[59]</a> An estimated 0.5 to 2.0% of viral rhinosinusitis (VRS) will develop into bacterial infections in adults and 5 to 10% in children.<a href="#cite_note-pmid31613481-38">[38]</a> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=17" title="Edit section: Pathophysiology">edit</a>]</div> Chronic rhinosinusitis is multifactorial process hypothesized to be caused by inflammatory processes driven by dysfunction between local host and environmental interactions.<a href="#cite_note-:12-60">[60]</a> It is divided into two <a href="/wiki/Phenotype" title="Phenotype">phenotypes</a> that depend on the presence or absence of <a href="/wiki/Nasal_polyp" title="Nasal polyp">nasal polyps</a>.<a href="#cite_note-:22-61">[61]</a> Chronic rhinosinusitis with nasal polyps and chronic rhinosinusitis without nasal polyps are thought to have two different inflammatory pathways, with the latter form driven by a <a href="/wiki/Th1_response" class="mw-redirect" title="Th1 response">Th1 response</a> and the former driven by a <a href="/wiki/T_helper_cell" title="T helper cell">Th2 response</a>.<a href="#cite_note-62">[62]</a> Both pathways result in an increase in inflammatory molecules (<a href="/wiki/Cytokine" title="Cytokine">cytokines</a>). The Th1 response is characterized by secretion of <a href="/wiki/Interferon_gamma" title="Interferon gamma">interferon gamma</a>.<a href="#cite_note-:22-61">[61]</a> The Th2 response is characterized by secretion of <a href="/wiki/Interleukin-4_receptor" title="Interleukin-4 receptor">interleukin-4 receptor</a>, <a href="/wiki/Interleukin_5" title="Interleukin 5">interleukin 5</a>, and <a href="/wiki/Interleukin_13" title="Interleukin 13">interleukin 13</a>.<a href="#cite_note-:22-61">[61]</a> Both forms of chronic rhinosinusitis are considered to be highly heterogenous, each with the ability to demonstrate three inflammatory <a href="/wiki/Endotype" title="Endotype">endotypes</a>, the third being a <a href="/wiki/T_helper_cell" title="T helper cell">Th17 response</a>.<a href="#cite_note-:22-61">[61]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=18" title="Edit section: Diagnosis">edit</a>]</div> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=19" title="Edit section: Classification">edit</a>]</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png/200px-Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png" decoding="async" width="200" height="289" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png/300px-Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4e/Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png/400px-Otorhinolaryngology_-_Sinusitis_--_Smart-Servier.png 2x" data-file-width="792" data-file-height="1143" /></a><figcaption>Illustration depicting sinusitis, note the fluid in the sini</figcaption></figure> Sinusitis (or rhinosinusitis) is defined as an inflammation of the <a href="/wiki/Nasal_mucosa" title="Nasal mucosa">mucous membrane</a> that lines the <a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">paranasal sinuses</a> and is classified chronologically into several categories:<a href="#cite_note-Radojicic-63">[63]</a> <ul><li><a href="/wiki/Acute_(medicine)" title="Acute (medicine)">Acute</a> sinusitis – A new infection that may last up to four weeks and can be subdivided symptomatically into severe and nonsevere. Some use definitions up to 12 weeks.<a href="#cite_note-pmid25833927-1">[1]</a></li> <li>Recurrent acute sinusitis – Four or more full episodes of acute sinusitis that occur within one year</li> <li><a href="/wiki/Subacute" class="mw-redirect" title="Subacute">Subacute</a> sinusitis – An infection that lasts between four and 12 weeks, and represents a transition between acute and chronic infection.</li> <li><a href="/wiki/Chronic_(medicine)" class="mw-redirect" title="Chronic (medicine)">Chronic</a> sinusitis – When the signs and symptoms last for more than 12 weeks.<a href="#cite_note-pmid25833927-1">[1]</a></li> <li>Acute exacerbation of chronic sinusitis – When the signs and symptoms of chronic sinusitis exacerbate, but return to baseline after treatment.</li></ul> Roughly 90% of adults have had sinusitis at some point in their lives.<a href="#cite_note-64">[64]</a> <div class="mw-heading mw-heading3"><h3 id="Acute_2">Acute</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=20" title="Edit section: Acute">edit</a>]</div> Health care providers distinguish bacterial and viral sinusitis by <a href="/wiki/Watchful_waiting" title="Watchful waiting">watchful waiting</a>.<a href="#cite_note-pmid25833927-1">[1]</a> If a person has had sinusitis for fewer than 10 days without the symptoms becoming worse, then the infection is presumed to be viral.<a href="#cite_note-pmid25833927-1">[1]</a> When symptoms last more than 10 days or get worse in that time, then the infection is considered bacterial sinusitis.<a href="#cite_note-pmid17761281-65">[65]</a> Pain in the teeth and bad breath are also more indicative of bacterial disease.<a href="#cite_note-66">[66]</a> Imaging by either X-ray, CT or MRI is generally not recommended unless complications develop.<a href="#cite_note-pmid17761281-65">[65]</a> Pain caused by sinusitis is sometimes confused for pain caused by <a href="/wiki/Pulpitis" title="Pulpitis">pulpitis</a> (toothache) of the maxillary teeth, and vice versa. Classically, the increased pain when tilting the head forwards separates sinusitis from pulpitis.[<a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed">citation needed</a>] For cases of maxillary sinusitis, limited field <a href="/wiki/Cone_beam_computed_tomography" title="Cone beam computed tomography">CBCT</a> imaging, as compared to <a href="/wiki/Periapical" class="mw-redirect" title="Periapical">periapical</a> <a href="/wiki/Radiograph" class="mw-redirect" title="Radiograph">radiographs</a>, improves the ability to detect the teeth as the sources for sinusitis. A coronal CT picture may also be useful.<a href="#cite_note-American_Association_of_Endodontists-2018-59">[59]</a> <div class="mw-heading mw-heading3"><h3 id="Chronic_2">Chronic</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=21" title="Edit section: Chronic">edit</a>]</div> For sinusitis lasting more than 12 weeks, a <a href="/wiki/CT_scan" title="CT scan">CT scan</a> is recommended.<a href="#cite_note-pmid17761281-65">[65]</a> On a CT scan, acute sinus secretions have a <a href="/wiki/Radiodensity" title="Radiodensity">radiodensity</a> of 10 to 25 <a href="/wiki/Hounsfield_unit" class="mw-redirect" title="Hounsfield unit">Hounsfield units</a> (HU), but in a more chronic state they become more <a href="/wiki/Viscosity" title="Viscosity">viscous</a>, with a radiodensity of 30 to 60 HU.<a href="#cite_note-67">[67]</a> Nasal <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a> and clinical symptoms are also used to make a positive diagnosis.<a href="#cite_note-pmid18206715-28">[28]</a> A tissue sample for <a href="/wiki/Histology" title="Histology">histology</a> and <a href="/wiki/Cultures" class="mw-redirect" title="Cultures">cultures</a> can also be collected and tested.<a href="#cite_note-68">[68]</a> Nasal endoscopy involves inserting a flexible <a href="/wiki/Fiber-optic" class="mw-redirect" title="Fiber-optic">fiber-optic</a> tube with a light and camera at its tip into the nose to examine the nasal passages and sinuses. Sinus infections, if they result in tooth pain, usually present with pain involving more than one of the upper teeth, whereas a toothache usually involves a single tooth. Dental examination and appropriate radiography aid in ruling out pain arises from a tooth.<a href="#cite_note-Burket-2014-69">[69]</a> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 178.66666666667px"> <div class="thumb" style="width: 176.66666666667px;"><a href="/wiki/File:Sinuses_and_Sinusitis_(5937085231).jpg" class="mw-file-description" title="CT of chronic sinusitis"><img alt="CT of chronic sinusitis" src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1d/Sinuses_and_Sinusitis_%285937085231%29.jpg/265px-Sinuses_and_Sinusitis_%285937085231%29.jpg" decoding="async" width="177" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1d/Sinuses_and_Sinusitis_%285937085231%29.jpg/398px-Sinuses_and_Sinusitis_%285937085231%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1d/Sinuses_and_Sinusitis_%285937085231%29.jpg/531px-Sinuses_and_Sinusitis_%285937085231%29.jpg 2x" data-file-width="559" data-file-height="695" /></a></div> <div class="gallerytext">CT of chronic sinusitis</div> </li> <li class="gallerybox" style="width: 225.33333333333px"> <div class="thumb" style="width: 223.33333333333px;"><a href="/wiki/File:CT_of_chronic_sinusitis.jpg" class="mw-file-description" title="CT scan of chronic sinusitis, showing a filled right maxillary sinus with sclerotic thickened bone"><img alt="CT scan of chronic sinusitis, showing a filled right maxillary sinus with sclerotic thickened bone" src="//upload.wikimedia.org/wikipedia/commons/6/65/CT_of_chronic_sinusitis.jpg" decoding="async" width="224" height="220" class="mw-file-element" data-file-width="330" data-file-height="325" /></a></div> <div class="gallerytext"><a href="/wiki/CT_scan" title="CT scan">CT scan</a> of chronic sinusitis, showing a filled right maxillary sinus with sclerotic thickened bone</div> </li> <li class="gallerybox" style="width: 175.33333333333px"> <div class="thumb" style="width: 173.33333333333px;"><a href="/wiki/File:Brain_MRI_112010_rgbca.png" class="mw-file-description" title="MRI image showing sinusitis. Edema and mucosal thickening appears in both maxillary sinuses."><img alt="MRI image showing sinusitis. Edema and mucosal thickening appears in both maxillary sinuses." src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7f/Brain_MRI_112010_rgbca.png/260px-Brain_MRI_112010_rgbca.png" decoding="async" width="174" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7f/Brain_MRI_112010_rgbca.png/391px-Brain_MRI_112010_rgbca.png 1.5x, //upload.wikimedia.org/wikipedia/commons/7/7f/Brain_MRI_112010_rgbca.png 2x" data-file-width="398" data-file-height="504" /></a></div> <div class="gallerytext">MRI image showing sinusitis. Edema and mucosal thickening appears in both maxillary sinuses.</div> </li> <li class="gallerybox" style="width: 196.66666666667px"> <div class="thumb" style="width: 194.66666666667px;"><a href="/wiki/File:RtmaxobitinfectteethCT.png" class="mw-file-description" title="Maxillary sinusitis caused by a dental infection associated with periorbital cellulitis"><img alt="Maxillary sinusitis caused by a dental infection associated with periorbital cellulitis" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/45/RtmaxobitinfectteethCT.png/292px-RtmaxobitinfectteethCT.png" decoding="async" width="195" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/45/RtmaxobitinfectteethCT.png/439px-RtmaxobitinfectteethCT.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/45/RtmaxobitinfectteethCT.png/585px-RtmaxobitinfectteethCT.png 2x" data-file-width="1068" data-file-height="1205" /></a></div> <div class="gallerytext">Maxillary sinusitis caused by a dental infection associated with <a href="/wiki/Periorbital_cellulitis" title="Periorbital cellulitis">periorbital cellulitis</a></div> </li> <li class="gallerybox" style="width: 186.66666666667px"> <div class="thumb" style="width: 184.66666666667px;"><a href="/wiki/File:FrontalSinusitisMark.png" class="mw-file-description" title="Frontal sinusitis"><img alt="Frontal sinusitis" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/FrontalSinusitisMark.png/277px-FrontalSinusitisMark.png" decoding="async" width="185" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/FrontalSinusitisMark.png/416px-FrontalSinusitisMark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e0/FrontalSinusitisMark.png/555px-FrontalSinusitisMark.png 2x" data-file-width="736" data-file-height="875" /></a></div> <div class="gallerytext">Frontal sinusitis</div> </li> <li class="gallerybox" style="width: 226px"> <div class="thumb" style="width: 224px;"><a href="/wiki/File:Maxilar_sinusites.jpg" class="mw-file-description" title="X-ray of left-sided maxillary sinusitis marked by an arrow. There is lack of the air transparency indicating fluid in contrast to the other side."><img alt="X-ray of left-sided maxillary sinusitis marked by an arrow. There is lack of the air transparency indicating fluid in contrast to the other side." src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Maxilar_sinusites.jpg/336px-Maxilar_sinusites.jpg" decoding="async" width="224" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Maxilar_sinusites.jpg/504px-Maxilar_sinusites.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/3/3e/Maxilar_sinusites.jpg 2x" data-file-width="533" data-file-height="524" /></a></div> <div class="gallerytext"><a href="/wiki/Projectional_radiography" title="Projectional radiography">X-ray</a> of left-sided maxillary sinusitis marked by an arrow. There is lack of the air transparency indicating fluid in contrast to the other side.</div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=22" title="Edit section: Treatment">edit</a>]</div> <table style="float:right; width:40em; border:solid 1px #999999; margin:0 0 1em 1em;"> <caption style="background-color: #CCEEEE;">Treatments for sinusitis<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a><a href="#cite_note-71">[71]</a> </caption> <tbody><tr> <th scope="col">Treatment </th> <th scope="col">Indication </th> <th scope="col">Rationale </th></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">Time </th> <td>Viral and some bacterial sinusitis </td> <td>Sinusitis is usually caused by a virus which is not affected by antibiotics.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">Antibiotics </th> <td>Bacterial sinusitis </td> <td>Cases accompanied by extreme pain, skin infection, or which last a long time may be caused by bacteria.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;"><a href="/wiki/Nasal_irrigation" title="Nasal irrigation">Nasal irrigation</a> </th> <td><a href="/wiki/Nasal_congestion" title="Nasal congestion">Nasal congestion</a> </td> <td>Can provide relief by helping decongest.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;">Drink liquids </th> <td>Thick <a href="/wiki/Phlegm" title="Phlegm">phlegm</a> </td> <td>Remaining hydrated loosens mucus.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;"><a href="/wiki/Antihistamines" class="mw-redirect" title="Antihistamines">Antihistamines</a> </th> <td>Concern with <a href="/wiki/Allergies" class="mw-redirect" title="Allergies">allergies</a> </td> <td>Antihistamines do not relieve typical sinusitis or cold symptoms much; this treatment is not needed in most cases.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> <tr> <th scope="row" style="text-align:left; font-weight:normal;"><a href="/wiki/Nasal_spray" title="Nasal spray">Nasal spray</a> </th> <td>Desire for temporary relief </td> <td>Tentative evidence that it helps symptoms.<a href="#cite_note-pmid25892369-4">[4]</a> Does not treat cause. Not recommended for more than three days' use.<a href="#cite_note-American_Academy_of_Family_Physicians-2012-70">[70]</a> </td></tr> </tbody></table> Recommended treatments for most cases of sinusitis include rest and drinking enough water to thin the mucus.<a href="#cite_note-American_Academy_of_Allergy,_Asthma,_and_Immunology-2012-72">[72]</a> Antibiotics are not recommended for most cases.<a href="#cite_note-American_Academy_of_Allergy,_Asthma,_and_Immunology-2012-72">[72]</a><a href="#cite_note-73">[73]</a> Breathing low-temperature steam such as from a hot shower or <a href="/wiki/Gargling" title="Gargling">gargling</a> can relieve symptoms.<a href="#cite_note-American_Academy_of_Allergy,_Asthma,_and_Immunology-2012-72">[72]</a><a href="#cite_note-74">[74]</a> There is tentative evidence for <a href="/wiki/Nasal_irrigation" title="Nasal irrigation">nasal irrigation</a> in acute sinusitis, for example during <a href="/wiki/Upper_respiratory_infection" class="mw-redirect" title="Upper respiratory infection">upper respiratory infections</a>.<a href="#cite_note-pmid25892369-4">[4]</a> <a href="/wiki/Decongestant" title="Decongestant">Decongestant</a> <a href="/wiki/Nasal_spray" title="Nasal spray">nasal sprays</a> containing <a href="/wiki/Oxymetazoline" title="Oxymetazoline">oxymetazoline</a> may provide relief, but these medications should not be used for more than the recommended period. Longer use may cause <a href="/wiki/Rhinitis_medicamentosa" title="Rhinitis medicamentosa">rebound sinusitis</a>.<a href="#cite_note-75">[75]</a> It is unclear if nasal irrigation, <a href="/wiki/Antihistamine" title="Antihistamine">antihistamines</a>, or decongestants work in children with acute sinusitis.<a href="#cite_note-76">[76]</a> There is no clear evidence that plant extracts such as <a href="/wiki/Cyclamen_purpurascens" title="Cyclamen purpurascens">Cyclamen europaeum</a> are effective as an intranasal wash to treat acute sinusitis.<a href="#cite_note-77">[77]</a> Evidence is inconclusive on whether anti-fungal treatments improve symptoms or quality of life.<a href="#cite_note-78">[78]</a> <div class="mw-heading mw-heading3"><h3 id="Antibiotics">Antibiotics</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=23" title="Edit section: Antibiotics">edit</a>]</div> Most sinusitis cases are caused by viruses and resolve without antibiotics.<a href="#cite_note-pmid18206715-28">[28]</a> However, if symptoms do not resolve within 10 days, either <a href="/wiki/Amoxicillin" title="Amoxicillin">amoxicillin</a> or <a href="/wiki/Amoxicillin/clavulanate" class="mw-redirect" title="Amoxicillin/clavulanate">amoxicillin/clavulanate</a> are reasonable antibiotics for <a href="/wiki/Therapy#Lines_of_therapy" title="Therapy">first treatment</a> with <a href="/wiki/Amoxicillin/clavulanate" class="mw-redirect" title="Amoxicillin/clavulanate">amoxicillin/clavulanate</a> being slightly superior to <a href="/wiki/Amoxicillin" title="Amoxicillin">amoxicillin</a> alone but with more side effects.<a href="#cite_note-pmid33236525-79">[79]</a><a href="#cite_note-pmid18206715-28">[28]</a> A 2018 Cochrane review, however, found no evidence that people with symptoms lasting seven days or more before consulting their physician are more likely to have bacterial sinusitis as one study found that about 80% of patients have symptoms lasting more than 7 days and another about 70%.<a href="#cite_note-pmid30198548-80">[80]</a> Antibiotics are specifically not recommended in those with mild / moderate disease during the first week of infection due to risk of adverse effects, <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">antibiotic resistance</a>, and cost.<a href="#cite_note-81">[81]</a> <a href="/wiki/Fluoroquinolones" class="mw-redirect" title="Fluoroquinolones">Fluoroquinolones</a>, and a newer <a href="/wiki/Macrolide" title="Macrolide">macrolide</a> antibiotic such as <a href="/wiki/Clarithromycin" title="Clarithromycin">clarithromycin</a> or a <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a> like <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a>, are used in those who have severe allergies to <a href="/wiki/Penicillin" title="Penicillin">penicillins</a>.<a href="#cite_note-82">[82]</a> Because of increasing resistance to amoxicillin the 2012 guideline of the <a href="/wiki/Infectious_Diseases_Society_of_America" title="Infectious Diseases Society of America">Infectious Diseases Society of America</a> recommends amoxicillin-clavulanate as the initial treatment of choice for bacterial sinusitis.<a href="#cite_note-pmid22438350-83">[83]</a> The guidelines also recommend against other commonly used antibiotics, including <a href="/wiki/Azithromycin" title="Azithromycin">azithromycin</a>, <a href="/wiki/Clarithromycin" title="Clarithromycin">clarithromycin</a>, and <a href="/wiki/Trimethoprim/sulfamethoxazole" title="Trimethoprim/sulfamethoxazole">trimethoprim/sulfamethoxazole</a>, because of growing antibiotic resistance. The <a href="/wiki/FDA" class="mw-redirect" title="FDA">FDA</a> recommends against the use of <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">fluoroquinolones</a> when other options are available due to higher risks of serious <a href="/wiki/Side_effect" title="Side effect">side effects</a>.<a href="#cite_note-84">[84]</a> A short-course (3–7 days) of antibiotics seems to be just as effective as the typical longer-course (10–14 days) of antibiotics for those with clinically diagnosed acute bacterial sinusitis without any other severe disease or complicating factors.<a href="#cite_note-85">[85]</a> The <a href="/wiki/Infectious_Diseases_Society_of_America" title="Infectious Diseases Society of America">IDSA</a> guideline suggest five to seven days of antibiotics is long enough to treat a bacterial infection without encouraging resistance. The guidelines still recommend children receive antibiotic treatment for ten days to two weeks.<a href="#cite_note-pmid22438350-83">[83]</a> <div class="mw-heading mw-heading3"><h3 id="Corticosteroids">Corticosteroids</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=24" title="Edit section: Corticosteroids">edit</a>]</div> For unconfirmed acute sinusitis, <a href="/wiki/Nasal_spray#Corticosteroid" title="Nasal spray">nasal sprays</a> using <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroids</a> have not been found to be better than a <a href="/wiki/Placebo" title="Placebo">placebo</a> either alone or in combination with antibiotics.<a href="#cite_note-86">[86]</a> For cases confirmed by radiology or nasal endoscopy, treatment with intranasal corticosteroids alone or in combination with antibiotics is supported.<a href="#cite_note-87">[87]</a> The benefit, however, is small.<a href="#cite_note-88">[88]</a> For confirmed chronic rhinosinusitis, there is limited evidence that intranasal steroids improve symptoms and insufficient evidence that one type of steroid is more effective.<a href="#cite_note-89">[89]</a><a href="#cite_note-90">[90]</a> There is only limited evidence to support short treatment with corticosteroids by mouth for chronic rhinosinusitis with nasal polyps.<a href="#cite_note-91">[91]</a><a href="#cite_note-pmid17844873-92">[92]</a><a href="#cite_note-93">[93]</a> There is limited evidence to support corticosteroids by mouth in combination with antibiotics for acute sinusitis; it has only short-term effect improving the symptoms.<a href="#cite_note-94">[94]</a><a href="#cite_note-95">[95]</a> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=25" title="Edit section: Surgery">edit</a>]</div> For sinusitis of dental origin, treatment focuses on removing the infection and preventing reinfection, by removal of the <a href="/wiki/Microorganism" title="Microorganism">microorganisms</a>, their byproducts, and pulpal debris from the infected <a href="/wiki/Root_canal" title="Root canal">root canal</a>.<a href="#cite_note-American_Association_of_Endodontists-2018-59">[59]</a> Systemic <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> are ineffective as a definitive solution, but may afford temporary relief of symptoms by improving sinus clearing, and may be appropriate for rapidly spreading infections, but <a href="/wiki/Debridement" title="Debridement">debridement</a> and disinfection of the root canal system at the same time is necessary. Treatment options include non-surgical <a href="/wiki/Root_canal_treatment" title="Root canal treatment">root canal treatment</a>, <a href="/wiki/Periradicular_surgery" title="Periradicular surgery">periradicular surgery</a>, <a href="/wiki/Tooth_replantation" title="Tooth replantation">tooth replantation</a>, or extraction of the infected tooth.<a href="#cite_note-American_Association_of_Endodontists-2018-59">[59]</a> For chronic or recurring sinusitis, referral to an <a href="/wiki/Otolaryngology" class="mw-redirect" title="Otolaryngology">otolaryngologist</a> may be indicated, and treatment options may include nasal surgery. Surgery should only be considered for those people who do not benefit with medication or have non-invasive fungal sinusitis<a href="#cite_note-96">[96]</a>[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">unreliable medical source?</a>].<a href="#cite_note-pmid17844873-92">[92]</a><a href="#cite_note-97">[97]</a> It is unclear how benefits of surgery compare to medical treatments in those with nasal polyps as this has been poorly studied.<a href="#cite_note-98">[98]</a><a href="#cite_note-99">[99]</a> A number of surgical approaches can be used to access the sinuses and these have generally shifted from external/extranasal approaches to intranasal <a href="/wiki/Endoscopic" class="mw-redirect" title="Endoscopic">endoscopic</a> ones. The benefit of <a href="/wiki/Functional_endoscopic_sinus_surgery" title="Functional endoscopic sinus surgery">functional endoscopic sinus surgery</a> (FESS) is its ability to allow for a more targeted approach to the affected sinuses, reducing tissue disruption, and minimizing post-operative complications.<a href="#cite_note-100">[100]</a> However, if a traditional FESS with Messerklinger technique is followed the success rate will be as low as 30%, 70% of the patients tend to have recurrence within 3 years.<a href="#cite_note-Medyblog-Meghanadh-2023-101">[101]</a>[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">unreliable medical source?</a>] On the other hand with use of TFSE technique along with navigation system, debriders and balloon sinuplasty or EBS can give a success rate of over 99.9%.<a href="#cite_note-Medyblog-Meghanadh-2023-101">[101]</a>[<a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)">unreliable medical source?</a>] The use of <a href="/wiki/Bioresorbable_stents" class="mw-redirect" title="Bioresorbable stents">drug eluting stents</a> such as <a href="/wiki/Propel_mometasone_furoate_implant" class="mw-redirect" title="Propel mometasone furoate implant">propel mometasone furoate implant</a> may help in recovery after surgery.<a href="#cite_note-102">[102]</a> Another recently developed treatment is <a href="/wiki/Balloon_sinuplasty" title="Balloon sinuplasty">balloon sinuplasty</a>. This method, similar to <a href="/wiki/Balloon_angioplasty" class="mw-redirect" title="Balloon angioplasty">balloon angioplasty</a> used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner.<a href="#cite_note-pmid21735433-42">[42]</a> The effectiveness of the functional endoscopic balloon dilation approach compared to conventional FESS is not known.<a href="#cite_note-pmid21735433-42">[42]</a> <a href="/wiki/Histopathology" title="Histopathology">Histopathology</a> of sinonasal contents removed from surgery can be diagnostically valuable: <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 202.66666666667px"> <div class="thumb" style="width: 200.66666666667px;"><a href="/wiki/File:Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation,_annotated.jpg" class="mw-file-description" title="Benign chronic mixed inflammation of an inflammatory sinonasal polyp."><img alt="Benign chronic mixed inflammation of an inflammatory sinonasal polyp." src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg/301px-Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg" decoding="async" width="201" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg/452px-Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg/602px-Histopathology_of_sinonasal_inflammatory_polyp_with_mixed_inflammation%2C_annotated.jpg 2x" data-file-width="2048" data-file-height="1532" /></a></div> <div class="gallerytext">Benign chronic mixed inflammation of an inflammatory sinonasal polyp.</div> </li> <li class="gallerybox" style="width: 202.66666666667px"> <div class="thumb" style="width: 200.66666666667px;"><a href="/wiki/File:Histopathology_of_acute_sinusitis.png" class="mw-file-description" title="Acute inflammation characterized by neutrophils."><img alt="Acute inflammation characterized by neutrophils." src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Histopathology_of_acute_sinusitis.png/301px-Histopathology_of_acute_sinusitis.png" decoding="async" width="201" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Histopathology_of_acute_sinusitis.png/452px-Histopathology_of_acute_sinusitis.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Histopathology_of_acute_sinusitis.png/602px-Histopathology_of_acute_sinusitis.png 2x" data-file-width="2048" data-file-height="1532" /></a></div> <div class="gallerytext">Acute inflammation characterized by <a href="/wiki/Neutrophil" title="Neutrophil">neutrophils</a>.</div> </li> <li class="gallerybox" style="width: 202.66666666667px"> <div class="thumb" style="width: 200.66666666667px;"><a href="/wiki/File:Histopathology_of_extranodal_NK-T_cell_lymphoma,_nasal_type.png" class="mw-file-description" title="Extranodal NK/T cell lymphoma, nasal type.[103] It may be incidentally discovered in people undergoing surgery for sinusitis.[104]"><img alt="Extranodal NK/T cell lymphoma, nasal type.[103] It may be incidentally discovered in people undergoing surgery for sinusitis.[104]" src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c4/Histopathology_of_extranodal_NK-T_cell_lymphoma%2C_nasal_type.png/301px-Histopathology_of_extranodal_NK-T_cell_lymphoma%2C_nasal_type.png" decoding="async" width="201" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/c/c4/Histopathology_of_extranodal_NK-T_cell_lymphoma%2C_nasal_type.png 1.5x" data-file-width="357" data-file-height="267" /></a></div> <div class="gallerytext"><a href="/wiki/Extranodal_NK/T_cell_lymphoma,_nasal_type" class="mw-redirect" title="Extranodal NK/T cell lymphoma, nasal type">Extranodal NK/T cell lymphoma, nasal type</a>.<a href="#cite_note-103">[103]</a> It may be incidentally discovered in people undergoing surgery for sinusitis.<a href="#cite_note-pmid28652944-104">[104]</a> </div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Treatments_directed_to_rhinovirus_infection">Treatments directed to rhinovirus infection</h3>[<a href="/w/index.php?title=Sinusitis&action=edit&section=26" title="Edit section: Treatments directed to rhinovirus infection">edit</a>]</div> A study has shown that patients given spray formulation of 0.73 mg of Tremacamra (a soluble intercellular adhesion molecule 1 [ICAM-1] receptor) reduced the severity of illness.<a href="#cite_note-pmid31430424-39">[39]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=27" title="Edit section: Prognosis">edit</a>]</div> A 2018 review has found that without the use of antibiotics, about 46% were cured after one week and 64% after two weeks.<a href="#cite_note-pmid30198548-80">[80]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=28" title="Edit section: Epidemiology">edit</a>]</div> Sinusitis is a common condition, with between 24 and 31 million cases occurring in the United States annually.<a href="#cite_note-105">[105]</a><a href="#cite_note-106">[106]</a> Chronic sinusitis affects approximately 12.5% of people.<a href="#cite_note-pmid21890184-48">[48]</a> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=29" title="Edit section: Research">edit</a>]</div> Based on recent theories on the role that <a href="/wiki/Fungi" class="mw-redirect" title="Fungi">fungi</a> may play in the development of chronic sinusitis, <a href="/wiki/Antifungal" title="Antifungal">antifungal treatments</a> have been used, on a trial basis. These trials have had mixed results.<a href="#cite_note-pmid18206715-28">[28]</a> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=30" title="Edit section: See also">edit</a>]</div> <ul><li><a href="/wiki/Fungal_sinusitis" title="Fungal sinusitis">Fungal sinusitis</a></li> <li><a href="/wiki/Odontogenic_sinusitis" title="Odontogenic sinusitis">Odontogenic sinusitis</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Sinusitis&action=edit&section=31" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-pmid25833927-1">^ <a href="#cite_ref-pmid25833927_1-0">a</a> <a href="#cite_ref-pmid25833927_1-1">b</a> <a href="#cite_ref-pmid25833927_1-2">c</a> <a href="#cite_ref-pmid25833927_1-3">d</a> <a href="#cite_ref-pmid25833927_1-4">e</a> <a href="#cite_ref-pmid25833927_1-5">f</a> <a href="#cite_ref-pmid25833927_1-6">g</a> <a href="#cite_ref-pmid25833927_1-7">h</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFRosenfeldPiccirilloChandrasekharBrook2015" class="citation journal cs1">Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, et al. 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Philadelphia: Elsevier Saunders. p. 687. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780323085939" title="Special:BookSources/9780323085939"><bdi>9780323085939</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160603211855/https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687">Archived</a> from the original on 2016-06-03.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Middleton%27s+allergy%3A+principles+and+practice&rft.place=Philadelphia&rft.pages=687&rft.edition=Eight&rft.pub=Elsevier+Saunders&rft.date=2014&rft.isbn=9780323085939&rft.aulast=Adkinson&rft.aufirst=N.+Franklin&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DvT9YAQAAQBAJ%26pg%3DPA687&rfr_id=info%3Asid%2Fen.wikipedia.org%3ASinusitis" class="Z3988"> </li> <li id="cite_note-pmid258339275-10"><a href="#cite_ref-pmid258339275_10-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRosenfeldPiccirilloChandrasekharBrook2015" class="citation journal cs1">Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Kumar KA, Kramper M, et al. 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Philadelphia: Elsevier Saunders. p. 687. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9780323085939" title="Special:BookSources/9780323085939"><bdi>9780323085939</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160603211855/https://books.google.com/books?id=vT9YAQAAQBAJ&pg=PA687">Archived</a> from the original on 2016-06-03.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Middleton%27s+allergy%3A+principles+and+practice&rft.place=Philadelphia&rft.pages=687&rft.edition=Eight&rft.pub=Elsevier+Saunders&rft.date=2014&rft.isbn=9780323085939&rft.aulast=Adkinson&rft.aufirst=N.+Franklin&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DvT9YAQAAQBAJ%26pg%3DPA687&rfr_id=info%3Asid%2Fen.wikipedia.org%3ASinusitis" class="Z3988"> </li> <li id="cite_note-12"><a href="#cite_ref-12">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAdkinsonMiddleton2014" class="citation book cs1">Adkinson NF, Middleton E, eds. 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class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q183344" class="extiw" title="d:Q183344">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#509821856">CA01</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1836987572">CA0A</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/J01">J01</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/J32">J32</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=461">461</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=473">473</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D012852">D012852</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb12136.htm">12136</a></li><li><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a>: <a rel="nofollow" class="external text" href="http://snomed.info/id/36971009">36971009</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000647.htm">000647</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/232670-overview">article/232670</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/sinusitis-pro">Sinusitis</a></li></ul></div></div></td></tr></tbody></table></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/sinusitis.html">"Sinusitis"</a>. MedlinePlus. U.S. National Library of Medicine.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=MedlinePlus&rft.atitle=Sinusitis&rft_id=https%3A%2F%2Fmedlineplus.gov%2Fsinusitis.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ASinusitis" class="Z3988"></li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_respiratory_system" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Respiratory_pathology" title="Template:Respiratory pathology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Respiratory_pathology" title="Template talk:Respiratory pathology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Respiratory_pathology" title="Special:EditPage/Template:Respiratory pathology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_respiratory_system" style="font-size:114%;margin:0 4em"><a href="/wiki/Respiratory_disease" title="Respiratory disease">Diseases of the respiratory system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">Upper RT</a> (including <a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">URTIs</a>, <a href="/wiki/Common_cold" title="Common cold">common cold</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_head" title="Human head">Head</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinuses</a></dt> <dd></dd> <dd><a class="mw-selflink selflink">Sinusitis</a></dd></dl> <dl><dt><a href="/wiki/Human_nose" title="Human nose">nose</a></dt> <dd></dd> <dd><a href="/wiki/Rhinitis" title="Rhinitis">Rhinitis</a> <dl><dd><a href="/wiki/Nonallergic_rhinitis" title="Nonallergic rhinitis">Vasomotor rhinitis</a></dd> <dd><a href="/wiki/Chronic_atrophic_rhinitis" title="Chronic atrophic rhinitis">Atrophic rhinitis</a></dd> <dd><a href="/wiki/Allergic_rhinitis" title="Allergic rhinitis">Hay fever</a></dd></dl></dd> <dd><a href="/wiki/Nasal_polyp" title="Nasal polyp">Nasal polyp</a></dd> <dd><a href="/wiki/Rhinorrhea" title="Rhinorrhea">Rhinorrhea</a></dd> <dd><a href="/wiki/Nasal_septum" title="Nasal septum">nasal septum</a> <dl><dd><a href="/wiki/Nasal_septum_deviation" title="Nasal septum deviation">Nasal septum deviation</a></dd> <dd><a href="/wiki/Nasal_septum_perforation" title="Nasal septum perforation">Nasal septum perforation</a></dd> <dd><a href="/wiki/Nasal_septal_hematoma" title="Nasal septal hematoma">Nasal septal hematoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/Tonsil" title="Tonsil">tonsil</a></dt> <dd></dd> <dd><a href="/wiki/Tonsillitis" title="Tonsillitis">Tonsillitis</a></dd> <dd><a href="/wiki/Adenoid_hypertrophy" title="Adenoid hypertrophy">Adenoid hypertrophy</a></dd> <dd><a href="/wiki/Peritonsillar_abscess" title="Peritonsillar abscess">Peritonsillar abscess</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neck" title="Neck">Neck</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/Pharynx" title="Pharynx">pharynx</a></dt> <dd></dd> <dd><a href="/wiki/Pharyngitis" title="Pharyngitis">Pharyngitis</a> <dl><dd><a href="/wiki/Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Strep throat</a></dd></dl></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Retropharyngeal_abscess" title="Retropharyngeal abscess">Retropharyngeal abscess</a></dd></dl> <dl><dt><a href="/wiki/Larynx" title="Larynx">larynx</a></dt> <dd></dd> <dd><a href="/wiki/Croup" title="Croup">Croup</a></dd> <dd><a href="/wiki/Laryngomalacia" title="Laryngomalacia">Laryngomalacia</a></dd> <dd><a href="/wiki/Laryngeal_cyst" title="Laryngeal cyst">Laryngeal cyst</a></dd> <dd><a href="/wiki/Laryngitis" title="Laryngitis">Laryngitis</a></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Laryngospasm" title="Laryngospasm">Laryngospasm</a></dd></dl> <dl><dt><a href="/wiki/Vocal_cords" title="Vocal cords">vocal cords</a></dt> <dd></dd> <dd><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</dd> <dd><a href="/wiki/Vocal_cord_nodule" title="Vocal cord nodule">Vocal fold nodule</a></dd> <dd><a href="/wiki/Vocal_cord_paresis" title="Vocal cord paresis">Vocal fold paresis</a></dd> <dd><a href="/wiki/Vocal_cord_dysfunction" title="Vocal cord dysfunction">Vocal cord dysfunction</a></dd></dl> <dl><dt><a href="/wiki/Epiglottis" title="Epiglottis">epiglottis</a></dt> <dd></dd> <dd><a href="/wiki/Epiglottitis" title="Epiglottitis">Epiglottitis</a></dd></dl> <dl><dt><a href="/wiki/Trachea" title="Trachea">trachea</a></dt> <dd></dd> <dd><a href="/wiki/Tracheitis" title="Tracheitis">Tracheitis</a></dd> <dd><a href="/wiki/Laryngotracheal_stenosis" title="Laryngotracheal stenosis">Laryngotracheal stenosis</a></dd></dl> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lower_respiratory_tract" class="mw-redirect" title="Lower respiratory tract">Lower RT</a>/ <a href="/wiki/Respiratory_disease" title="Respiratory disease">lung disease</a> (including <a href="/wiki/Lower_respiratory_tract_infection" title="Lower respiratory tract infection">LRTIs</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bronchus" title="Bronchus">Bronchial</a>/ <a href="/wiki/Obstructive_lung_disease" title="Obstructive lung disease">obstructive</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt>acute</dt> <dd></dd> <dd><a href="/wiki/Acute_bronchitis" title="Acute bronchitis">Acute bronchitis</a></dd></dl> <dl><dt>chronic</dt> <dd></dd> <dd><a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">COPD</a> <dl><dd><a href="/wiki/Bronchitis#Chronic_bronchitis" title="Bronchitis">Chronic bronchitis</a></dd> <dd><a href="/wiki/Acute_exacerbation_of_chronic_obstructive_pulmonary_disease" title="Acute exacerbation of chronic obstructive pulmonary disease">Acute exacerbation of COPD</a>)</dd> <dd><a href="/wiki/Asthma" title="Asthma">Asthma</a> (<a href="/wiki/Status_asthmaticus" class="mw-redirect" title="Status asthmaticus">Status asthmaticus</a></dd> <dd><a href="/wiki/Aspirin-exacerbated_respiratory_disease" title="Aspirin-exacerbated respiratory disease">AERD</a></dd> <dd><a href="/wiki/Exercise-induced_asthma" class="mw-redirect" title="Exercise-induced asthma">Exercise-induced</a></dd></dl></dd> <dd><a href="/wiki/Bronchiectasis" title="Bronchiectasis">Bronchiectasis</a></dd> <dd><a href="/wiki/Cystic_fibrosis" title="Cystic fibrosis">Cystic fibrosis</a></dd></dl> <dl><dt>unspecified</dt> <dd></dd> <dd><a href="/wiki/Bronchitis" title="Bronchitis">Bronchitis</a></dd> <dd><a href="/wiki/Bronchiolitis" title="Bronchiolitis">Bronchiolitis</a> <dl><dd><a href="/wiki/Bronchiolitis_obliterans" title="Bronchiolitis obliterans">Bronchiolitis obliterans</a></dd></dl></dd> <dd><a href="/wiki/Diffuse_panbronchiolitis" title="Diffuse panbronchiolitis">Diffuse panbronchiolitis</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Interstitial_lung_disease" title="Interstitial lung disease">Interstitial</a>/ <a href="/wiki/Restrictive_lung_disease" title="Restrictive lung disease">restrictive</a> (<a href="/wiki/Pulmonary_fibrosis" title="Pulmonary fibrosis">fibrosis</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">External agents/ <a href="/wiki/Occupational_disease" title="Occupational disease">occupational</a> <a href="/wiki/Occupational_lung_disease" title="Occupational lung disease">lung disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dd><a href="/wiki/Pneumoconiosis" title="Pneumoconiosis">Pneumoconiosis</a> <dl><dd><a href="/wiki/Aluminosis" title="Aluminosis">Aluminosis</a></dd> <dd><a href="/wiki/Asbestosis" title="Asbestosis">Asbestosis</a></dd> <dd><a href="/wiki/Baritosis" title="Baritosis">Baritosis</a></dd> <dd><a href="/wiki/Bauxite_fibrosis" title="Bauxite fibrosis">Bauxite fibrosis</a></dd> <dd><a href="/wiki/Berylliosis" title="Berylliosis">Berylliosis</a></dd> <dd><a href="/wiki/Caplan%27s_syndrome" title="Caplan's syndrome">Caplan's syndrome</a></dd> <dd><a href="/wiki/Chalicosis" title="Chalicosis">Chalicosis</a></dd> <dd><a href="/wiki/Coalworker%27s_pneumoconiosis" class="mw-redirect" title="Coalworker's pneumoconiosis">Coalworker's pneumoconiosis</a></dd> <dd><a href="/wiki/Siderosis" title="Siderosis">Siderosis</a></dd> <dd><a href="/wiki/Silicosis" title="Silicosis">Silicosis</a></dd> <dd><a href="/wiki/Pulmonary_talcosis" title="Pulmonary talcosis">Talcosis</a></dd> <dd><a href="/wiki/Byssinosis" title="Byssinosis">Byssinosis</a></dd></dl></dd></dl> <dl><dd><a href="/wiki/Hypersensitivity_pneumonitis" title="Hypersensitivity pneumonitis">Hypersensitivity pneumonitis</a> <dl><dd><a href="/wiki/Bagassosis" title="Bagassosis">Bagassosis</a></dd> <dd><a href="/wiki/Bird_fancier%27s_lung" title="Bird fancier's lung">Bird fancier's lung</a></dd> <dd><a href="/wiki/Farmer%27s_lung" title="Farmer's lung">Farmer's lung</a></dd> <dd><a href="/wiki/Lycoperdonosis" title="Lycoperdonosis">Lycoperdonosis</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">ARDS</a></li> <li><a href="/wiki/Combined_pulmonary_fibrosis_and_emphysema" title="Combined pulmonary fibrosis and emphysema">Combined pulmonary fibrosis and emphysema</a></li> <li><a href="/wiki/Pulmonary_edema" title="Pulmonary edema">Pulmonary edema</a></li> <li><a href="/wiki/L%C3%B6ffler%27s_syndrome" title="Löffler's syndrome">Löffler's syndrome</a>/<a href="/wiki/Eosinophilic_pneumonia" title="Eosinophilic pneumonia">Eosinophilic pneumonia</a></li> <li><a href="/wiki/Respiratory_hypersensitivity" class="mw-redirect" title="Respiratory hypersensitivity">Respiratory hypersensitivity</a> <ul><li><a href="/wiki/Allergic_bronchopulmonary_aspergillosis" title="Allergic bronchopulmonary aspergillosis">Allergic bronchopulmonary aspergillosis</a></li></ul></li> <li><a href="/wiki/Hamman%E2%80%93Rich_syndrome" class="mw-redirect" title="Hamman–Rich syndrome">Hamman–Rich syndrome</a></li> <li><a href="/wiki/Idiopathic_pulmonary_fibrosis" title="Idiopathic pulmonary fibrosis">Idiopathic pulmonary fibrosis</a></li> <li><a href="/wiki/Sarcoidosis" title="Sarcoidosis">Sarcoidosis</a></li> <li><a href="/wiki/Vaping-associated_pulmonary_injury" title="Vaping-associated pulmonary injury">Vaping-associated pulmonary injury</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Obstructive / Restrictive</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a>/ <a href="/wiki/Pneumonitis" title="Pneumonitis">pneumonitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">By pathogen</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Viral_pneumonia" title="Viral pneumonia">Viral</a></li> <li><a href="/wiki/Bacterial_pneumonia" title="Bacterial pneumonia">Bacterial</a> <ul><li><a href="/wiki/Pneumococcal_infection" title="Pneumococcal infection">Pneumococcal</a></li> <li><a href="/wiki/Klebsiella_pneumoniae#Klebsiella_pneumonia" title="Klebsiella pneumoniae">Klebsiella</a></li></ul></li> <li><a href="/wiki/Atypical_pneumonia" title="Atypical pneumonia">Atypical bacterial</a> <ul><li><a href="/wiki/Mycoplasma_pneumonia" title="Mycoplasma pneumonia">Mycoplasma</a></li> <li><a href="/wiki/Legionellosis" class="mw-redirect" title="Legionellosis">Legionnaires' disease</a></li> <li><a href="/wiki/Chlamydiota" title="Chlamydiota">Chlamydiae</a></li></ul></li> <li><a href="/wiki/Fungal_pneumonia" title="Fungal pneumonia">Fungal</a> <ul><li><a href="/wiki/Pneumocystis_pneumonia" title="Pneumocystis pneumonia">Pneumocystis</a></li></ul></li> <li><a href="/wiki/Parasitic_pneumonia" title="Parasitic pneumonia">Parasitic</a></li> <li>noninfectious <ul><li><a href="/wiki/Chemical_pneumonia" class="mw-redirect" title="Chemical pneumonia">Chemical</a>/<a href="/wiki/Mendelson%27s_syndrome" title="Mendelson's syndrome">Mendelson's syndrome</a></li> <li><a href="/wiki/Aspiration_pneumonia" title="Aspiration pneumonia">Aspiration</a>/<a href="/wiki/Lipid_pneumonia" title="Lipid pneumonia">Lipid</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By vector/route</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Community-acquired_pneumonia" title="Community-acquired pneumonia">Community-acquired</a></li> <li><a href="/wiki/Healthcare-associated_pneumonia" class="mw-redirect" title="Healthcare-associated pneumonia">Healthcare-associated</a></li> <li><a href="/wiki/Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By distribution</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bronchopneumonia" title="Bronchopneumonia">Broncho-</a></li> <li><a href="/wiki/Lobar_pneumonia" title="Lobar pneumonia">Lobar</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Idiopathic_interstitial_pneumonia" title="Idiopathic interstitial pneumonia">IIP</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Usual_interstitial_pneumonia" title="Usual interstitial pneumonia">UIP</a></li> <li><a href="/wiki/Desquamative_interstitial_pneumonia" title="Desquamative interstitial pneumonia">DIP</a></li> <li><a href="/wiki/Bronchiolitis_obliterans_organizing_pneumonia" class="mw-redirect" title="Bronchiolitis obliterans organizing pneumonia">BOOP-COP</a></li> <li><a href="/wiki/Nonspecific_interstitial_pneumonia" class="mw-redirect" title="Nonspecific interstitial pneumonia">NSIP</a></li> <li><a href="/wiki/Respiratory_bronchiolitis" title="Respiratory bronchiolitis">RB</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atelectasis" title="Atelectasis">Atelectasis</a></li> <li>circulatory <ul><li><a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a></li> <li><a href="/wiki/Pulmonary_embolism" title="Pulmonary embolism">Pulmonary embolism</a></li></ul></li> <li><a href="/wiki/Lung_abscess" title="Lung abscess">Lung abscess</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pleural_cavity" title="Pleural cavity">Pleural cavity</a>/ <a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pleural_disease" title="Pleural disease">Pleural disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pleurisy" title="Pleurisy">Pleuritis/pleurisy</a></li></ul> <ul><li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a>/<a href="/wiki/Hemopneumothorax" title="Hemopneumothorax">Hemopneumothorax</a></li></ul> <dl><dt><a href="/wiki/Pleural_effusion" title="Pleural effusion">Pleural effusion</a></dt> <dd></dd> <dd><a href="/wiki/Hemothorax" title="Hemothorax">Hemothorax</a></dd> <dd><a href="/wiki/Hydrothorax" title="Hydrothorax">Hydrothorax</a></dd> <dd><a href="/wiki/Chylothorax" title="Chylothorax">Chylothorax</a></dd> <dd><a href="/wiki/Pleural_empyema" title="Pleural empyema">Empyema/pyothorax</a></dd> <dd><a href="/wiki/Malignant_pleural_effusion" title="Malignant pleural effusion">Malignant</a></dd></dl> <dl><dd><a href="/wiki/Fibrothorax" title="Fibrothorax">Fibrothorax</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mediastinal_disease" class="mw-redirect" title="Mediastinal disease">Mediastinal disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mediastinitis" title="Mediastinitis">Mediastinitis</a></li> <li><a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">Mediastinal emphysema</a></li></ul> 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