title: A Practical Approach to Refractory Chronic Rhinosinusitis.
abstract: Patients with refractory chronic rhinosinusitis, by definition, have persistent, poorly controlled symptoms and objective inflammatory findings despite prior medical and surgical therapy. These patients represent a diagnostic and treatment challenge given the complexity of the underlying disease factors and the limitations in available management options. This article presents a practical framework for clinical evaluation and treatment. Germane to discussion are emerging concepts in refractory chronic rhinosinusitis that will likely have important implications in the near future.
authors.affiliation: Department of Otorhinolaryngology, Ochsner Clinic Foundation, 1514 Jefferson Hwy, CT-4, New Orleans, LA 70121, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: McCoul
authors.affiliation: Department of Otolaryngology, Weill Cornell Medicine, 1305 York Avenue, 5th Floor, New York, NY 10021, USA. Electronic address: atabaee@hotmail.com.
authors.forename: Abtin
authors.initials: A
authors.lastname: Tabaee
mesh_terms: D002908:Chronic Disease; D019468:Disease Management; D006801:Humans; D009298:Nasal Polyps / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012220:Rhinitis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012852:Sinusitis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D017211:Treatment Failure
keywords: Chronic rhinosinusitis; Nasal polyps; Sinus surgery; Topical therapy