Ngày tải lên :
19/02/2014, 08:20
... Whichrequireapproximately1week for regeneration
B. Whichrequireapproximately6weeks for regeneration
C. Whichrequireapproxi mately12weeks for regeneration
D. Whichrequireapproximately6months for regeneration
E. ... )was for children12years
oryounger.(5‐7)Aprimarydiagnosisofacuteorchronicsinusitisaccounted for 58.7%ofallexpenditures($3.5
billion).(5‐7)Itisestimatedthat2.2billiondollarsisspentyearly
onprescriptionandnonprescriptionmedication.
(5‐7)About12%eachofthecosts for asthmaandchronicotitismediaand eustachiantubedisorderswere
45
Allergicand Non AllergicSinusitis for thePrimaryCarePhysician:
Pathophysiology,EvaluationandTreatment
CHAPTER4
ALLERGYANDSINUSDISEASE
INTRODUCTION
AccordingtotheAmericanAcademyofAllergy,Asthma,andImmunology(AAAAI),over50million
Americanssufferfromsomeformofallergiesthatgreatlyimpactstheirqualityoflifeaswellashealthcarecoststhat
areestimatedatapproximately20billiondollarsayear.(
1)Allergicrhinitisaloneisestimatedtoaffect20to30
millionAmericanseachyearandaccounts for anestimated3%ofallmedicalofficevisitsandranksasthesecond
mostcommonreasonpatientsseekprofessionalhealthcare.(1)InmanygeographicareasoftheUnitedStates,
allergiesplay
asignificantroleascontributoryfactorsofsinusdiseaseaswellassecondarycauseofsinusinfections.
Itisofgreatvaluetothepractitionertounderstandtheunderlyingimmunologicfactors,availablediagnostictests
andtreatments.(2‐8)
Itisespeciallyvaluable for thepractitionertobewellversedin
allergybecausemanypatientsareconfused
aboutthedifferencebetweensinusitis ... arance.”
Rhinology.
2006;44(3):193‐6.
23.BoatsmanJ,CalhounK,RyanM.“RelationshipBetweenRhinosinusitisSymptomsandMucociliaryClearance
Time.”OtolaryngolHeadNeckSurg.2006;134(3):491‐493.
24.BeckerDG.SeptoplastyandTurbinateSurgery.AestheticSurgJ2003;23:393‐403.
25.CookPR,BegegniA,BryantC,DavisWE.Effectofpartialmiddleturbinectomyon
nasalairflowandresistance.
OtolaryngolHeadNeckSurg1995;113:413‐419.
26.PankeyGA,GrossCW,MendelsohnMG.ContemporaryDiagnosisandManagementofSinusitis.NewtownPA:
HandbooksinHealthCare,2000.
27.FacerGW,KernEB.Sinusitis:currentconceptsandmanagement.In:BaileyBJ,editor.HeadandNeckSurgery–
Otolaryngology.Philadelphia,PA:
JBLippincott,1993.
28.ReulerJB,LucasLM,KumarKL.Sinusitis.Areview for generalists.WestJMed1995;163:40–48.
29.StammbergerH.FunctionalEndoscopicSinusSurgery.Philadelphia,PA:BCDecker,1991.
19
Allergicand Non AllergicSinusitis for thePrimaryCarePhysician:
Pathophysiology,EvaluationandTreatment
CHAPTER2
SIGNSANDSYMPTOMSOFSINUSDISEASE
SinusitisisoneofthemostcommonhealthcarecomplaintsintheUnitedStates.(1‐8)Approximately1in8
peopleintheUnitedStateswillhavesinusitisatonetimeintheirlives.TheNationalCenter for DiseaseStatistics
reports
thatsinusitisisnowthenumberonechronicillness for allagegroupsintheUnitedStates.The1993National
HealthInterviewSurveyfoundthatsinusitiswasthemostcommonlyreportedchronicdisease,affecting
approximately14%oftheUnitedStatespopulation,andAnandreporteda16%incidenceinhis2004
study.(9)A
2006studybyKoyandCoonsontheincidenceofchronicconditionsreportedthatapproximatelythree‐fifths
(62.5%)ofthestudysamplereportedatleastoneof18chronicmedicalconditions;sinusitis(24.8%)wasthemost
commonlyreportedcondition,followedbyhypertension(23.5%)andarthritis(21.5%).(
10)
Sinusdiseaseaffectsroughly31millionpeopleannually.Furthermore,10%ofthepopulationsuffersfrom
allergicsinusdisease.Between1990and1992,reportsindicatedthatsinusitissufferershadapproximately73
milliondaysofrestrictedactivity—a50%increasefrom4yearsearlier.Sinusitisaccounted for nearly25million
physicianoffice
visitsintheUnitedStatesin1993and1994.(Ofcourse,manymorecasesareunreported,andmany
patientssufferwithoutseeingaphysician,sothetrueincidenceofsinusitisisunknown.)Althoughtheyaretypically
notseriousandrespondpromptlytopropermedicaltreatment,inflammatorydiseasesofthesinusesare
aleading
causeoflossofproductivitybothatworkandatschool.
RhinosinusitisposesanimmenseeconomicburdenintheUnitedStates.(9)Thecostoftreatingsinus
diseaserunsintothebillionsofdollars,withouttakingintoaccountlossofwork.Overallhealthcareexpenditures
attributableto
sinusitisin1996wereestimatedat$5...