Pharmacologic management of chronic rhinosinusitis, alone or with nasal polyposis.
Patients with chronic rhinosinusitis (CRS) and chronic rhinosinusitis with nasal polyposis (CRSwNP) commonly present with nasal obstruction, nasal discharge, facial pressure/pain, and hyposmia of prolonged duration. Recent evidence suggests that, despite clinical similarities, CRS and CRSwNP are distinct entities with separate inflammatory pathways and cytokine profiles. Antibiotics and nasal steroids are the mainstay of treatment in CRS, whereas combination systemic and nasal steroids are the foundation of CRSwNP management. Allergy therapy may play a significant role in CRS, whereas antileukotriene therapy has demonstrated promise in CRSwNP. Although prolonged medical therapy is usually necessary with both disorders, surgery may also be required to relieve refractory symptoms, and to improve sinus aeration and nasal access for topical therapy.
Department of Otolaryngology-Head and Neck Surgery, PO Box 250550, 135 Rutledge Avenue, Charleston, SC 29425, USA.
M Boyd
MB
Gillespie
J David
JD
Osguthorpe
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D015897:Comorbidity; D004359:Drug Therapy, Combination; D006801:Humans; D007249:Inflammation; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D015508:Nasal Obstruction; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy*; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D020024:Leukotriene Antagonists