Kronisk rinosinuit
Senast uppdaterad: Senast reviderad:
Sakkunnig:Morgan Andersson
Definition:
Symtom och tecken på inflammation i en eller flera av de paranasala bihålorna och i nässlemhinnan med varaktighet över 12 veckor.
Förekomst:
Vanligast bland yngre och medelålders personer.
Symtom:
Vanliga symtom är varig snuva, smärta/tryck i ansiktet och nedsatt luktsinne.
Kliniska fynd:
Pus i en eller bägge näskaviteterna, speciellt lokaliserat till mellersta näsgången, eventuellt näspolyper vid kronisk rinosinuit med polypos.
Diagnostik:
Rhinoskopi som påvisar typiska kliniska fynd. DT är vid oklarheter om diagnosen, när medicinsk behandling har misslyckats, när det uppstår komplikationer och vid misstänkt malignitet.
Behandling:
Nässköljning med koksaltlösning, intranasala kortikosteroider och i vissa fall antibiotika används vid behandlingen. Eventuell astma behandlas. I vissa fall kan kirurgi vara av värde.
- Läkemedel vid rinosinuit – behandlingsrekommendation (Läkemedelsverket; 2020)
- Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1‐464.
- Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016; 6 suppl 1: S22-209
- Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1‐464. PMID:32077450. PubMed
- Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA²LEN study. Allergy 2011; 66(9): 1216-23. pmid:21605125 PubMed
- Bhattacharyya N. Incremental health care utilization and expenditures for chronic rhinosinusitis in the United Stats. Ann Otol Rhinol Laryngol 2011; 120(7): 423-7. pmid:21859049 PubMed
- Larsen K, Tos M. The estimated incidence of symptomatic nasal polyps. Acta Otolaryngol. 2002;122:179–182. PMID:11936910. PubMed
- Lusk R. Chronic rhinosinusitis: contrasts between children and adult patients. Clin Allergy Immunol 2007; 20: 287. PubMed
- Hamilos DL. Chronic rhinosinusitis patterns of illness. Clin Allergy Immunol 2007; 20: 1. PubMed
- Läkemedelsverket. Läkemedel vid rinosinuit – behandlingsrekommendation. 2020-06-25 (Hämtad 2020-06-25). www.lakemedelsverket.se
- Berrettini S, Carabelli A, Sellari-Franceschini S, et al. Perennial allergic rhinitis and chronic sinusitis: correlation with rhinologic risk factors. Allergy 1999; 54: 242. PubMed
- Tammemagi CM, Davis RM, S Benninger M, Holm AL, Krajenta R. Secondhand smoke as a potential cause of chronic rhinosinusitis: a case-control study. Arch Otolaryngol Head Neck Surg 2010; 136: 327-34. PubMed
- Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016; 6 suppl 1: S22-209. pmid:26889651 PubMed
- Schreiber CP, Hutchinson S, Webster CJ, Ames M, Richardson MS, Powers C. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache. Arch Intern Med 2004; 164: 1769-72. PubMed
- Hamilos DL. Clinical manifestations, pathophysiology, and diagnosis of chronic rhinosinusitis. UpToDate, last updated June 13, 2011. UpToDate
- Jani AL, Hamilos DL. Current thinking on the relationship between rhinosinusitis and asthma. J Asthma 2005; 42: 1. PubMed
- Makowska J, Lewandowska-Polak A, Kowalski ML, et al. Hypersensitivity to Aspirin and other NSAIDs: Diagnostic Approach in Patients with Chronic Rhinosinusitis. Curr Allergy Asthma Rep. 2015 Aug;15(8):47. PubMed
- Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004; 114 (6 Suppl): 155.
- The Royal College of Radiologists. Making the best use of a Department of Clinical Radiology. Guidelines for doctors. Fourth edition. London: The Royal College of Radiologists, 1998
- Wuister AM, Goto NA, Oostveen EJ, et al. Nasal endoscopy is recommended for diagnosing adults with chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2014 Mar;150(3):359-64. doi: 10.1177/0194599813514510. DOI
- Head K, Chong LY, Piromchai P, et al. Systemic and topical antibiotics for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 26;4: CD011994. pmid:27113482 PubMed
- Wei CC, Adappa ND, Cohen NA. Use of topical nasal therapies in the management of chronic rhinosinusitis. Laryngoscope. 2013 Oct;123(10):2347-59. PMID: 23553558. PubMed
- Darrell R, Guthmann R. Which treatments are safe and effective for chronic sinusitis?. J Family Practice 2016; 11: 829-31. www.researchgate.net
- Chong LY, Head K, Hopkins C, et al. Saline irrigation for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 26;4: CD011995. pmid:27115216 PubMed
- Scadding GK, Durham SR, Mirakian R, et al, British Society for Allergy and Clinical Immunology. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy 2008; 38: 260. PubMed
- Lund VJ, Black JH, SzabóLZ, Schrewelius C, Akerlund A. Efficacy and tolerability of budesonide aqueous nasal spray in chronic rhinosinusitis patients. Rhinology 2004; 42: 57. PubMed
- Rudmik L, Soler ZM, et al. Medical Therapies for Adult Chronic Sinusitis: A Systematic Review. JAMA. 2015 Sep 1;314(9):926-39. PubMed
- Aanæs K, Alanin MC, Arndal E et al.. Kronisk bihulebetændelse og type 2-sygdom. Ugeskr Læger 2022; 184: V05210446. ugeskriftet.dk
- Chong LY, Piromchai P, Sharp S, et al. Biologics for chronic rhinosinusitis. Cochrane Database Syst Rev. 2021;3(3):CD013513. Published 2021 Mar 12. DOI:10.1002/14651858.CD013513.pub3. DOI
- Rix I, Håkansson K, Larsen CG, et al. Management of chronic rhinosinusitis with nasal polyps and coexisting asthma: A systematic review. Am J Rhinol Allergy 2015; May-Jun;29(3): 193-201. pmid:25975250 PubMed
- Mafee MF. Imaging of paranasal sinuses and rhinosinusitis. Clin Allergy Immunol 2007; 20: 185. PubMed
- Morgan Andersson, docent och överläkare, Öron-, näs- och halskliniken, Skånes universitetssjukhus
- Remy Waardenburg, specialist i allmänmedicin, Vårdcentralen Hökarängen