Diagnosis of sinusitis in adults: history, physical examination, nasal cytology, echo, and rhinoscope.

The symptoms of sinusitis are common and overlap other diseases ranging from common colds to perennial rhinitis. When symptoms are prolonged and interfere with daily living, an appropriate set of investigations are indicated. The workup is designed to detect both the presence and extent of any disease in the paranasal sinus cavities. In chronic sinusitis, a constellation of nonspecific symptoms such as facial pressure, headache, nasal obstruction, and drainage may occur. Physical examination is important to exclude anatomic causes of symptoms. A negative physical examination does not rule out the diagnosis. Adjunctive tests in selected cases include nasal cytologic studies, ultrasound studies, and the use of flexible or rigid nasal endoscopes, in addition to imaging tests such as radiology and computed tomography.