title: Chronic rhinosinusitis: the rationale for current treatments.
abstract: Chronic rhinosinusitis (CRS) is a broad clinical syndrome linked by mucosal inflammation. Primary treatment modalities are corticosteroids and antibiotics with surgery an option for failures, but the level of supporting evidence is generally low. The primary reason is that CRS is a symptom complex and not a specific disease. Areas covered: The primary treatment modalities for CRS are corticosteroids, antibiotics and surgery. Corticosteroids, which have very broad anti-inflammatory properties, also have the strongest evidence for efficacy. Antibiotics are likely effective in a subpopulation of patients but the various phenotypes and endotypes that make up CRS have thus far been poorly defined. Early surgery as well as biologics may also be more efficacious and cost effective in some phenotypes as well. Expert commentary: A better understanding of the inflammatory pathways that drive CRS will permit investigators to separate patient groups. This will allow for clinical trials that target specific subpopulations and more personalized therapy for CRS patients in the future.
authors: a Feinberg School of Medicine, Department of Otolaryngology, Head and Neck Surgery , Northwestern University , Chicago , IL , USA.
authors: Nsangou
authors: N
authors: Ghogomu
authors: a Feinberg School of Medicine, Department of Otolaryngology, Head and Neck Surgery , Northwestern University , Chicago , IL , USA.
authors: Robert
authors: R
authors: Kern
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001691:Biological Therapy; D002908:Chronic Disease; D004724:Endoscopy; D006801:Humans; D010256:Paranasal Sinuses / Q000473:pathology* / Q000601:surgery; D020545:Respiratory Mucosa / Q000276:immunology*; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents
keywords: Chronic rhinosinusitis; antimicrobials; biologics; corticosteroids; endoscopic sinus surgery; recurrent acute sinusitis