First-line management of sinusitis: a national problem? Overview.

Traditional concepts of sinus disease as primarily involving the maxillary sinuses are giving way to understanding of the primary involvement of the ostiomeatal complex. Recognition of predisposing factors is also improving, as is localization of disease in the ethmoid, maxillary, frontal, and sphenoid sinuses. Because of the interdependence of the sinuses, acute sinusitis is rarely limited to one sinus. The diagnosis of acute disease is relatively easy compared with that of chronic sinusitis, which mimics many other conditions. Antibiotics and decongestants typically constitute initial therapy for acute sinusitis, and surgery is reserved for patients with threatened complications. The principal goal of this symposium is to outline the most rational approach to treatment of sinus disease on the basis of currently available diagnostic and therapeutic techniques. Emphasis will be placed on first-line management, on therapeutic response, and on objective evaluation of therapeutic efficiency.