Web Site Reviews of Common Medical Conditions: General Health
Alex M. Westenfield M4, Michael P. D'Alessandro M.D, Paul R.
Pomrehn MD, Jeffrey R. Galvin M.D.
Peer Review Status:Internally Reviewed by
Author
University of Iowa Family Practice Handbook - Nasal Problems : Acute Sinusitis
Author and/or Publisher: Joseph Lucero, M.D., Department of Family Practice, University of Iowa College of Medicine. Published by Mosby-YearBook, Inc.
Date of Publication: 1994
MESH Indexing Terms: sinusitis
Document Type: Textbook
Date of Review: 1/27/97>
Reviewed by: Richard J. Smith, M.D., Professor, Department of Otolaryngology, University of Iowa College of Medicine
Comments: This review article on sinusitis contains some misconceptions. First, the author states that if "second line" antibiotic therapy is required, a CT scan should be done. Actually, it is more cost effective to do the CT scan after completing second-line antibiotic therapy to evaluate the status of the sinuses at that time. Second, the author then states that foreign bodies can be removed from the nose by inflating a balloon. This is virtually impossible in young children and I wouldn't recommend trying this maneuver. Third, the author states that it is acceptable to delay x-ray examiniation of nasal fractures until a follow-up appointment. In practice, the x-ray examination may be totally unnecessary. Rarely does an x-ray help if it is a simple nasal fracture. Fourth, the author states that using cocaine or tetracaine/epinephrine in the treatment of epistaxis is satisfactory. I think it is easier to use Xylocaine (2%) and Oxymetazoline (Afrin). These medicines are safer and easier to keep in a clinic. Finally, the author states that the nasopulmonary reflux drops PO2 by 15 mm Hg in all persons who have their noses packed. This is generally not true In fact, packing noses has very little effect on PO2.
National Jewish Center for Immunology and Respiratory Medicine MedFacts : Sinusitis
Author and/or Publisher: National Jewish Center for Immunology and Respiratory Medicine
Date of Publication: 1993
MESH Indexing Terms: sinusitis
Document Type: Booklet
Date of Review: 1/27/97
Reviewed by: Richard J. Smith, M.D., Professor, Department of Otolaryngology, University of Iowa College of Medicine
Comments: This general review article is quite accurate. Note that the antihistamine Terfenadine is being removed from the market and will be replaced by Allegra which does not have the adverse cardiac side effects of Terfenadine.
American Academy of Family Physicians Health Information : How to Help Your Sinus Problems
Author and/or Publisher: American Academy of Family Physicians
Date of Publication: 1996
MESH Indexing Terms: sinusitis
Document Type: Booklet
Date of Review:1/27/97
Reviewed by: Richard J. Smith, M.D., Professor, Department of Otolaryngology, University of Iowa College of Medicine
Comments: This article is a simple review that does not go into the detail offered by the other articles.
Author and/or Publisher: American Academy of Otolaryngology
Date of Publication: 1995
MESH Indexing Terms: sinusitis
Document Type: Booklet
Date of Review: 1/27/97
Reviewed by: Richard J. Smith, M.D., Professor, Department of Otolaryngology, University of Iowa College of Medicine
Comments: This article adds no information to the other articles. It does contain some misconceptions. The article makes a reference to antihistamines, but does not offer any warning about the morbidity and possible mortality associated with Seldane use.
National Institute of Allergy and Infectious Diseases Fact Sheet : Sinusitis
Author and/or Publisher: National Institutes of Health
Date of Publication: 1996
MESH Indexing Terms: sinusitis
Document Type: Booklet
Date of Review: 1/27/97
Reviewed by: Richard J. Smith, M.D., Professor, Department of Otolaryngology, University of Iowa College of Medicine
Comments: This review article is generally quite accurate. However, it contains two errors. The authors state that "a thin tube can be inserted into the sinuses for washing out entrapped pus and mucus". This is not possible unless the person has had prior sinus surgery to enlarge the ostia. The article also states that "a bubble of air trapped within the body expands as air pressure in a plane is reduced. This expansion causes pressure on surrounding tissues...". This is incorrect. While the air does expand, the pressure is almost always sufficient to overcome the obstruction caused by the mucous membrane swelling around the openings of the sinuses. However, on descent, the swelling prevents air from reentering the sinuses. As a result, there is a negative pressure, bleeding into the sinuses and ensuing pain. The same physiology applies to the eustachian tubes. This point should be corrected.
Next Page | Previous Page | Section Top | Title Page