title: Canadian guidelines for chronic rhinosinusitis: Clinical summary.
abstract: OBJECTIVE
  To provide a clinical summary of the Canadian clinical practice guidelines for chronic rhinosinusitis (CRS) that includes recommendations relevant for family physicians.
  
  
  METHODS
  Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology-Head and Neck Surgery, Canadian Association of Emergency Physicians, and Family Physicians Airways Group of Canada).
  
  
  RESULTS
  Diagnosis of CRS is based on type and duration of symptoms and an objective finding of inflammation of the nasal mucosa or paranasal sinuses. Chronic rhinosinusitis is categorized based on presence or absence of nasal polyps, and this distinction leads to differences in treatment. Chronic rhinosinusitis with nasal polyps is treated with intranasal corticosteroids. Antibiotics are recommended when symptoms indicate infection (pain or purulence). For CRS without nasal polyps, intranasal corticosteroids and second-line antibiotics (ie, amoxicillin- clavulanic acid combinations or fluoroquinolones with enhanced Gram-positive activity) are recommended. Saline irrigation, oral steroids, and allergy testing might be appropriate. Failure of response should prompt consideration of alternative diagnoses and referral to an otolaryngologist. Patients undergoing endoscopic sinus surgery require postoperative treatment and follow-up.
  
  
  CONCLUSIONS
  The Canadian guidelines provide diagnosis and treatment approaches based on the current understanding of the disease and available evidence. Additionally, the guidelines provide the expert opinion of a diverse group of practice and academic experts to help guide clinicians where evidence is sparse.
authors: 17 Bedford Park Ave, Richmond Hill, ON L4C 2N9. for4kids@gmail.com.
authors: Alan
authors: A
authors: Kaplan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002170:Canada; D002908:Chronic Disease; D004724:Endoscopy; D005194:Family Practice; D006801:Humans; D009298:Nasal Polyps / Q000150:complications / Q000628:therapy; D017410:Practice Guidelines as Topic; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents