Chronic Sinusitis and Rhinitis

Abstract

In a 6-month period, 186 new patients with chronic nasal symptoms were evaluated. In addition to history and physical examination, all received sinus radiographs. A subset received epicutaneous skin tests to environmental aeroallergens. Patients were divided into five diagnostic categories to determine if history or physical findings could predict abnormal sinus radiographs. No symptom or group of symptoms proved diagnostic; however, no patient with allergic rhinitis had purulent nasal secretions. Positive skin tests occurred in the absence of typical allergy symptoms. Many patients had received inappropriate prior therapy with either surgery or antibiotics. We conclude that sinus radiographs should be obtained in all patients with chronic nasal symptoms not improved by routine therapy.