title: Chapter 4: Chronic rhinosinusitis.
abstract: Chronic rhinosinusitis (CRS) is the second most common chronic medical condition in the United States. It represents a group of disorders characterized by inflammation of the nasal mucosa and paranasal sinuses of at least 12 weeks duration. CRS with or without nasal polyps is defined as inflammation of the nose characterized by two or more symptoms, one of which should be either nasal blockage, obstruction, congestion, or nasal discharge (anterior/posterior nasal drip); with or without facial pain/pressure; and/or with or without reduction or loss of smell. Symptomatology should be supported by obvious disease evident in either nasal endoscopy or computed tomography imaging. Although CRS is not likely to be cured by either medical or surgical therapy, it can generally be controlled. Best medical evidence supports maintenance therapy with intranasal corticosteroids and saline irrigation. For exacerbations, short to intermediate courses of antibiotics (up to 4-weeks) with or without oral corticosteroids are recommended. For patients with difficult-to-treat CRS, functional endoscopic sinus surgery provides an adjunctive therapeutic option.
authors.affiliation: Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. russell_settipane@brown.edu
authors.forename: Russell A
authors.initials: RA
authors.lastname: Settipane
authors.forename: Anju T
authors.initials: AT
authors.lastname: Peters
authors.forename: Rakesh
authors.initials: R
authors.lastname: Chandra
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000818:Animals; D002908:Chronic Disease; D018450:Disease Progression; D004724:Endoscopy; D006801:Humans; D009297:Nasal Mucosa / Q000276:immunology*; D009298:Nasal Polyps / Q000276:immunology / Q000628:therapy*; D010256:Paranasal Sinuses / Q000276:immunology*; D012220:Rhinitis / Q000276:immunology / Q000628:therapy*; D012852:Sinusitis / Q000276:immunology / Q000628:therapy*; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones