Chronic rhinosinusitis: observation or treatment

Curr Opin Allergy Clin Immunol. 2013 Feb;13(1):31-6. doi: 10.1097/ACI.0b013e32835ad0ba.

Abstract

Purpose of review: Several treatment options have been proposed for chronic rhinosinusitis (CRS). Our purpose is to present a protocol/tool to treat patient symptoms, which is initially independent of assessment for presence of CRS.

Recent findings: This protocol is called the Rational Patient Experiment (RPE), and its concept is largely based on the fact that CRS is overrepresented in incidence based on surveys, because symptoms of CRS are nonspecific and overlap multiple other disorders. Patients whose symptoms persist, despite the RPE, require further objective assessment of CRS with endoscopy and computed tomography.

Summary: This review outlines the RPE and the evidence base for observation versus treatment with saline washes, steroids, or antibiotics.

Publication types

  • Review

MeSH terms

  • Administration, Intranasal
  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Clinical Protocols
  • Humans
  • Rhinitis / diagnosis
  • Rhinitis / drug therapy*
  • Rhinitis / etiology
  • Sinusitis / diagnosis
  • Sinusitis / drug therapy*
  • Sinusitis / etiology

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents