Use of nasopharyngeal culture to determine appropriateness of antibiotic therapy in acute bacterial rhinosinusitis.

Background: Rhinosinusitis is one of the top 5 diagnoses for which an antibiotic is prescribed, often without a clear bacterial etiology. This study evaluated whether nasopharyngeal culture and gram stain could serve as a surrogate for endoscopically obtained middle meatal cultures in directing appropriate therapy for acute bacterial rhinosinusitis (ABRS). This study also investigated the utility of a rapid sinus test screen in differentiating bacterial from nonbacterial rhinosinusitis.

Physical findings in allergy.

Allergies are typically diagnosed based on detailed history elicited from a patient. Confirmation of the diagnosis by allergy skin or in vitro testing is sometimes also helpful. The authors discuss several physical examination features, specifically in the head and neck region, that are often suggestive of allergy presence.

Relapsing polychondritis: a rare etiology of dysphonia and novel approach to treatment.

Relapsing polychondritis affects the airway in half of all diagnosed patients. The traditional approach to the treatment of relapsing polychondritis in all sites is oral steroids and other immune-modulating drugs. We present a case of laryngeal relapsing polychondritis treated with local injections of steroid in the face of oral therapy failure.

Recalcitrant chronic rhinosinusitis: investigation and management.

Purpose Of Review: We discuss the care of patients failing the typical medical and surgical management for chronic rhinosinusitis who need further evaluation to rule out various mimics of sinus disease and other disorders that may require specific treatment plans. We also look at the many treatment options for the recalcitrant sinusitis patient recently published.

Recent Findings: Work-up of diseases such as gastroesophageal reflux, dental infection and immunodeficiency in the chronic rhinosinusitis patient are discussed.