| N˚ | Questions | Responses | Codages | |
| Identifiant | ||||
| Q1 | Number of file |
| ... | |
| Socio-démographic data | ||||
| Q2 | Age (year) |
| ... | |
| Q3 | Sex | 1-Male 2-Femal | ... | |
| Q4 | socio-professionnal Occupation | 1-Pupils/students 2-Workers exposed to dust 3-Housewives 4-teacher 5-other to precise | ... | |
|
| Ethnic group | 1-Fon 2-Mina 3-Yoruba 4-Bariba 5-Dendi 6-Non beninese |
| |
| Q5 | Place of residence | 1-Cotonou 2-Outside Cotonou | ... | |
| Clinical caracteristics | ||||
| Q6 | Delay before Consultation (in number of days) | a-1 à 7 b-8 à 14 c-15 à 21 d-21 à 28 e-> 28 f-unspecify |
| |
| Q7 | Triggering circumstance | 1-Acute rhinitis 2-Tooth decay 3-Facial bone trauma 4-Nasosinus polyposis |
| |
| General signs and background | ||||
| Q8 | Change in general condition | 1-Present 2-Absent | ... | |
| Q9 | Medical background | 1-None 2-Diabet 3-HBP 4-Atopic terrain 5-sickle cell disease 6-other | ... | |
| Symptoms | ||||
| Q10 | Latérality of symptoms | 1-Unilateral 2-Bilateral | ... | |
| Q11 | if unilateral | 1-Right 2-left | ... | |
| Q12 | Nasal obstruction | 1-Present 2-Absent | ... | |
| Q13 | Rhinorrhea | 1-Présent 2-Absent | ... | |
| Q14 | Aspect of rhinorrhea | 1-Mucosa 2-Purulent 3-Bloody 4-Muco-purulent | ... | |
| Q15 | Type of rhinorrhea | 1-Antérior 2-Postérior | ... | |
| Q16 | headaches | 1-Present 2-Absent | ... | |
| Q17 | Headquarters of headaches | 1-Sus-orbital 2-Infra-orbital 3-Occipital 4 -Temporal | ... | |
| Q18 | Sneeze | 1-Present 2-Absent | ... | |
| Q19 | Smell disorder | 1-Present 2-Absent | ... | |
| Q20 | Type of smell disorder | 1-Anosmy 2-Hyposmy 3-Cacosmy 4-Parosmy | ... | |
| Q21 | Duration of evolution | 1-inferior to 4 weeks 2-sup to 12 weeks | ... | |
| Q22 | Installation mod | 1-Sudden 2-Progressif |
| |
| Q23 | Mode d’évolution | 1-Intermittent 2-Permanent |
| |
| Physical exam | ||||
| Q24 | Anterior Rhinoscopy | 1-purulent secretion at the middle meatus 2-endo-nasal mass 3-nasal Congestion 4-Turbinal hypertrophy | ... | |
| Q25 | Statut of nasal septum | 1-normal 2-deviation | ... | |
| Q26 | Bucco-pharyngal exam | 1-Normal 2-Tooth decay 3-other | ... | |
| Q27 | pain of sinus points | 1-Suborbital 2-canine pit 3-Sus-orbitaire |
| |
| Radiologic caracteristics | ||||
| Q28 | Imaging examination performed | 1-Rx of sinus Blondeau 2-TDM of sinus 3-IRM des sinus |
| |
| Q29 | Topography of sinusitis | 1-Maxillar 2-Frontal 3-Ethmoïd 4-Sphénoïd | ... | |
| Q30 | Type of lésion radiologic lesion | 1-sinus opacity 2-hydroaeric level 3-Thickening of the sinus framework 4-sinus veil | ... | |
| Treatment and évolution | ||||
| Q31 | Type of treatment | 1-Médical 2-Médico-surgical | ... | |
| Q32 | Antibiothérapy | 1-Amoxicillin + clavulanic acid 2-Fluoroquinolones 3-Macrolides 4-Cephalosporin of 3rd generation 5-Unspecified | ... | |
| Q33 | Analgesic | 1-stage 1 2-stage 2 3-None | ... | |
| Q34 | Antiinflammatory | 1-stéroïdal Antiinflammatory 2-Nonsteroidal anti-inflammatory 3-Bronchic antiinflammatory 4-None | ... | |
| Q35 | Décongestionnant nasal | 1-Vasoconstrictor simple 2-Vasoconstrictor + antiseptic + mucolytic 3-physiologic serum 4-none | ... | |
| Q36 | Antiallergy | 1-oral 2-nasal | ... | |
| Q37 | Surgical Treatment | 1-yes 2-No | ... | |
| Q38 | Evolution | 1-Favorable 2-Non favorable | ... | |