Symptoms of rhinosinusitis

This issue of our Journal contains a very interesting review from Eccles. Eccles discusses the four primary symptoms used to diagnose rhinosinusitis: nasal obstruction, nasal discharge, facial pain and loss of sense of smell; and the secondary symptoms, cough, sneezing, sore throat and voice changes, epiphora, fever, and psychological effects and fatigue. From the Byzantine time and Hippocrates to recent times definition of nasal disease has been discussed. It is interesting how little we know about the role symptoms of rhinitis and rhinosinusitis play in the diagnosis and evaluation of treatment of the disease. Although a number of guidelines and consensus documents have been developed, there are considerable differences in diagnostic criteria and a lack of an accepted gold standard diagnosis. The term rhinosinusitis is now widely acknowledged and most people accept that rhinitis can occur without sinusitis but sinusitis not or only very seldom without rhinitis