title: Evidence-based treatment of chronic rhinosinusitis with nasal polyps.
abstract: BACKGROUND
  Chronic rhinosinusitis with nasal polyps (CRSwNPs) is the most challenging form of CRS to treat. Clinical practices vary widely among physicians around the world, often with little evidence to support current therapies.
  
  
  METHODS
  This study evaluates various medical and surgical treatments with a focus on the highest levels of evidence. Recommendations for various therapies are provided based on consensus panels and evidence-based reviews.
  
  
  RESULTS
  Therapies with the strongest evidence and recommendations for CRSwNPs include oral steroids and topical nasal steroid sprays. There is also reasonable evidence for surgery, to include perioperative oral steroids and postoperative oral antibiotics for at least 2 weeks. There is little evidence to support other therapies, including commonly used modalities such as oral antibiotics, antihistamines, and immunotherapy.
  
  
  CONCLUSIONS
  CRSwNPs is a heterogenous disorder that currently has very few therapies supported by strong evidence. It is likely that in the near future, a more refined understanding of CRSwNPs will permit clinicians to tailor therapies using high-level evidence with improved outcomes.
authors.affiliation: Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
mesh_terms: D002908:Chronic Disease; D055317:Evidence-Based Practice; D006801:Humans; D009298:Nasal Polyps / Q000628:therapy*; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*