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Chronic sinusitis can be difficult to diagnose precisely and sometimes even more difficult to treat. Increasingly, experts are suggesting that antibiotics may be wildly overprescribed for this condition.
In this prospective study, patients referred to a single sinus expert for classic sinusitis symptoms were methodically evaluated with computed tomography (CT) scans and nasal endoscopy. Of 125 consecutive patients, only 75 (60%) had evidence of sinusitis on CT scan (meatal obstruction, air-fluid levels, or mucosal thickening [one area with >10 mm thickening, or any thickening involving at least 4 sinuses]). A decreased sense of smell predicted an abnormal CT scan, but headache, facial pain and difficulty sleeping were all more common in the …