TAILIEUCHUNG - The diagnosis and management of sinusitis: A practice parameter update

Sympathetic nerve stimulation induces vasoconstriction and consequent decreases nasal airway resistance. Parasympathetic nerve stimulation on the other hand, promotes secretion from nasal airway glands and nasal congestion. The nasal mucosa also contains nerves of the non-adrenergic, non-cholinergic (NANC)- system. Neuropeptides from the latter nerves (substance P, neurokinin A and K, and calcitonin gene-related peptide) are suspected to play a role in vasodilatation, mucus secretion, plasma extravasation, neurogenic inflammation, and mast cell nerve interactions. However, the magnitude of their role is uncertain . Further investigations concerning the role of the nervous system in ARS are required | The diagnosis and management of sinusitis A practice parameter update Chief Editors Raymond G. Slavin MD Sheldon L. Spector MD and I. Leonard Bernstein MD SinusitisUpdate Workgroup Chairman Raymond G. Slavin MD Members Michael A. Kaliner MD David W. Kennedy MD Frank S. Virant MD and Ellen R. Wald MD Joint Task Force Reviewers David A. Khan MD Joann Blessing-Moore MD David M. Lang MD Richard A. Nicklas MD John J. Oppenheimer MD Jay M. Portnoy MD Diane E. Schuller MD and Stephen A. Tilles MD Reviewers Larry Borish MD Robert A. Nathan MD Brian A. Smart MD and Mark L. Vandewalker MD These parameters were developed by the Joint Task Force on Practice Parameters representing theAmerỉcanAcademy of Allergy Asthma and Immunology the American College of Allergy Asthma and Immunology and the Joint Council of Allergy Asthma and Immunology. The American Academy of Allergy Asthma andỉmmunology AAAAI and the American College of Allergy Asthma and Immunology ACAAI have jointly accepted responsibility for establishing The diagnosis and management of sinusitis a practice parameter update. This is a complete and comprehensive document at the current time. The medical environment is a changing environment and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many This parameter was edited by Dr Nicklas in his private capacity and not in his capacity as a medical officer with the Food and Drug Administration. No official support or endorsement by the Food and Drug Administration is intended or should be inferred. Disclosure of potential conflict of interest E. Wald has received grants from GlaxoSmithKline MedImmune and Sanofi Pasteur. F. Virant has received grants from Abbott AstraZeneca Boehringer Ingelheim Bristol-Myers Squibb Dey Labs Genentech GlaxoSmithKline Hoffman LaRoche Immu-nex Key Lederle Lilly Research Merck Novartis Pfizer Purdue Fredrick Sandofi Schering Sepracor TAP Pharmaceuticals 3M Pharmaceuticals UCN .

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