title: Chronic rhinosinusitis management beyond intranasal steroids and saline solution irrigations.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) is a heterogeneous disease with clinical manifestations that are influenced by the presence or absence of nasal polyposis. Understanding of the current and future treatment modalities for CRS is essential in preventing exacerbation and morbidity associated with this chronic condition.
  
  
  OBJECTIVE
  The aim of this article is to review the evidence behind current medical therapies and potential new treatments for CRS.
  
  
  METHODS
  Scientific literature regarding intranasal and systemic antibiotics, intranasal systemic corticosteroids, and monoclonal antibodies as interventions for CRS with and without nasal polyps was reviewed.
  
  
  RESULTS
  The literature supports the use of topical or systemic glucocorticoids in patients with nasal polyps, and there appears to be a role for systemic antibiotics in the treatment of acute exacerbations of CRS with nasal polyps. The response to corticosteroids or antibiotics in the treatment of exacerbations of CRS without nasal polyps is variable. Due to the lack of appropriately designed trials, there is weak evidence for the adjunctive use of immunotherapy at this time. Monoclonal antibodies that target Immunoglobulin E and T helper cell 2 cytokines have been clinically effective in symptom reduction for some patients with CRS with nasal polyps although further studies are needed.
  
  
  CONCLUSIONS
  Current therapies used in the treatment of CRS are discussed.
authors: Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: Newton
authors: N
authors: Li
authors: Anju T
authors: AT
authors: Peters
mesh_terms: D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002908:Chronic Disease; D019468:Disease Management; D006801:Humans; D009298:Nasal Polyps / Q000628:therapy*; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D012965:Sodium Chloride / Q000627:therapeutic use; D007507:Therapeutic Irrigation
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D012965:Sodium Chloride