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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2004 June;54(2):63-70
Evaluation and treatment of chronic rhinosinusitis
Benninger M. S.
Department of Otolaryngology-Head and Neck Surgery Henry Ford Hospital, Detroit, MI, USA
Chronic rhinosinusitis (CRS) is a common condition affecting a large percentage of the population. Despite this high prevalence, it has been difficult to characterize CRS as it appears that it may be due to a number of different etiologies with markedly varied symptom complexes and severity. Recent definitions have defined CRS as a group of disorders rather than a specific disorder, and have acknowledged that the characteristic finding is inflammation, not necessarily with infection. Therefore, there may be a large number of factors and conditions that may be associated with CRS, either as an etiology or as a comorbidity. This paper will describe the prevalence, current definitions and methods of making the diagnosis of CRS, the multiple associated conditions, and potential etiologic mechanisms and common inflammatory pathways. In particular, the roles of allergy and infectious agents including bacteria and fungi are presented, as well as the recognition of the importance of eosinophilic inflammation and the growing interest in bacterial superantigens. A brief review of current approaches to therapy is introduced.