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David W. Kennedy, MD, Discussant

JAMA. 2000;283:2143-2150.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR PARKER: Mr S is a 48-year-old businessman plagued by recurrent sinusitis for the last 21 years. Frequent infections interfere with his quality of life. He resides near Boston and is covered by commercial insurance.

Mr S first experienced allergies and sinus infections when he moved to Oregon 21 years ago. After monthly episodes of sinusitis for more than a year, he underwent septoplasty, cauterization, and creation of "surgical windows" for improved drainage. He remained free of sinus infections for 1 year. Mr S then noted a pattern of sinus infections starting in the fall and lasting through the early spring. This coincided with his seasonal allergies, and he has received 4 series of allergy shots.

Mr S describes a typical episode as clogged ears and postnasal drip causing hoarseness, followed by facial pain and warmth, yellow nasal discharge, and general malaise and fatigue. He . . . [Full Text of this Article]

MR S: HIS UNDERSTANDINGS AND PERCEPTIONS

DR R: HIS UNDERSTANDING AND PERCEPTIONS

AT THE CROSSROADS: QUESTIONS TO DR KENNEDY

Risk Factors for Chronic Sinusitis

Differential Diagnosis

Evaluation

Treatment

Endoscopic Sinus Surgery

Appropriate Treatment for Mr S

QUESTIONS AND DISCUSSION

Author Affiliation: Dr Kennedy is Professor and Chair of the Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia.

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