What are the AAO-HNSF diagnostic guidelines for bacterial rhinosinusitis (RS)?

Updated: Mar 01, 2018
  • Author: Itzhak Brook, MD, MSc; Chief Editor: Michael Stuart Bronze, MD  more...
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The 2007 guidelines by the American Academy of Otolaryngology--Head and Neck Surgery Foundation [29] were updated in 2015 [30] and recommended that clinicians (1) reassess the patient to confirm acute bacterial rhinosinusitis, to exclude other causes of illness, and to detect complications if the patient worsens or fails to improve with the initial management option by 7 days after diagnosis or worsens during the initial management; (2) distinguish chronic sinusitis and recurrent acute sinusitis from isolated episodes of acute sinusitis and other causes of sinonasal symptoms; and (3) assess the patient with chronic sinusitis or recurrent acute sinusitis for multiple chronic conditions that would modify management, such as asthma, cystic fibrosis, immunocompromised state, and ciliary dyskinesia.

The 2015 guidelines [30] recommend that clinicians should not obtain radiographic imaging in patients who meet diagnostic criteria for acute sinusitis unless a complication or alternative diagnosis is suspected.

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