title: [Chronic rhinosinusitis with septal perforation. Differential diagnostic considerations].
abstract: Chronic rhinosinusitis together with nasal septal perforation with or without pain of the nasal skeleton and without previous trauma or surgery point toward the possible diagnosis of Wegener's granulomatosis. However, nasal biopsy and serologic testing remain inconclusive in many patients. The otolaryngologist's role in this situation is to initiate, in close cooperation with a rheumatologist, therapy with sulfatrimethoprim, as well as with immunosuppressants if necessary. This helps stabilize the symptomatology and may prevent progressive systemic disease.
authors.affiliation: HNO-Klinik und Poliklinik der Johannes-Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55131 Mainz, Deutschland. Mann@hno.klinik.uni-mainz.de
authors.forename: W
authors.initials: W
authors.lastname: Mann
authors.forename: P
authors.initials: P
authors.lastname: Bumb
authors.forename: E
authors.initials: E
authors.lastname: Märker-Hermann
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000473:pathology*; D009668:Nose Diseases / Q000150:complications* / Q000175:diagnosis*; D012220:Rhinitis / Q000150:complications* / Q000175:diagnosis*; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis*