Chronic rhinosinusitis without nasal polyps

Chronic rhinosinusitis is inflammation of the paranasal sinuses lasting more than 12 weeks.

Diagnosis is initially clinical. Nasal endoscopy may show inflammation, purulent discharge, edema, or frank polyps.

Initial medical treatment includes nasal saline irrigation and topical intranasal corticosteroids. Oral antibiotics, oral corticosteroids, antihistamines, and leukotriene receptor antagonists may also be considered.

Computed tomography is needed if initial medical treatment fails.

Functional endoscopic sinus surgery is very effective for patients unresponsive to medical treatment.

Chronic sinusitis, also known as chronic rhinosinusitis, is inflammation of the paranasal sinuses lasting more than 12 weeks. "Rhinosinusitis" is the preferred term as sinusitis is usually accompanied by nasal airway inflammation and is preceded by rhinitis in most cases.[1]Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg. 2004 Dec;131(6 suppl):S1-62. https://www.doi.org/10.1016/j.otohns.2004.09.067 http://www.ncbi.nlm.nih.gov/pubmed/15577816?tool=bestpractice.com

Symptoms include facial pressure, rhinorrhea, postnasal drainage, congestion, and general malaise.

Chronic rhinosinusitis is classified into two groups, with and without polyps, which have slightly different treatment regimens. This topic discusses chronic rhinosinusitis in the absence of polyps. For more information on nasal polyps, including diagnosis and management, please see Nasal polyps.