Nasal and XXXX : current diagnosis and treatment.

@entity1244 @entity1 @entity32 @entity66 @entity2704 @entity854 @entity158 @entity10 @entity50
@entity50 may result in disabling head and @entity158 and serious complications. Awareness of the symptoms of acute and chronic @entity1244 and their various presentations will enhance diagnostic accuracy and improve @entity1 outcome. It is important to remember that the nasal mucosa is under autonomic control. Sinus symptomatology, whether from @entity854 or @entity32 , may occur with and will typically be exacerbated by increased parasympathetic outflow or reduced sympathetic tone. Thus, the possibility of underlying intranasal or sinus disease must be considered in @entity1 with atypical @entity2704 headaches. A new appreciation of the impact of @entity1244 on facial and @entity10 syndromes is developing among otolaryngologists because of the improved diagnostic capabilities afforded by combined intranasal endoscopy and modified CT. In the past, @entity1 with nasal complaints and @entity158 who had normal plain radiographs were often passed off as "chronic nasal complainers" and given decongestants or the recommendation to see a psychiatrist. On the other hand, @entity1 with symptoms and @entity854 often underwent radical surgery aimed at the maxillary or frontal sinus, sometimes with persistence or worsening of their complaints. Now, however, underlying causes for these problems can often be found in the ostiomeatal complex and corrected with minimally invasive surgery. In general, the major sinuses appear to be more sensitive to @entity158 before the development of chronic mucosal changes. @entity66 in critical locations within the ostiomeatal complex may therefore give rise to greater symptomatology than @entity66 in less critical sites. Although head CT may be a routine part of the neurologist's examination in @entity1 with @entity10 or @entity158 , routine CT techniques are inadequate to evaluate fully the ostiomeatal complex and sinuses and must be modified to rule out adequately @entity158 of sinus origin. Nasal endoscopic examination provides a noninvasive examination by which @entity1 may be selected for sinus CT and is a necessary part of a complete evaluation. Close cooperation between the neurologist and otolaryngologist-head and neck surgeon is therefore essential for the accurate diagnosis of this often puzzling group of @entity1 .
