Chronic Rhinosinusitis: Contemporary Diagnosis and Evidence-Based Management

Dr. Surendra Kumar Sharma; Dr. Sharadkumar Pralhad Sawant

Chronic Rhinosinusitis: Contemporary Diagnosis and Evidence-Based Management

Author(s)	Dr. Surendra Kumar Sharma, Dr. Sharadkumar Pralhad Sawant
Country	India
Abstract	Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the nasal cavity and paranasal sinuses associated with substantial morbidity, impaired quality of life, sleep disturbance, and reduced productivity. Its clinical presentation is heterogeneous, reflecting differences in inflammatory mechanisms, anatomical factors, comorbidities, and disease phenotypes. Advances in endoscopic assessment, computed tomography, inflammatory profiling, and targeted biological therapies have transformed contemporary approaches to diagnosis and management. CRS is generally defined by the presence of characteristic sinonasal symptoms for at least 12 weeks, accompanied by objective evidence of inflammation on nasal endoscopy, anterior rhinoscopy, or computed tomography. Clinically, it is classified into chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). Accurate diagnosis requires careful history-taking, assessment of symptom burden, identification of associated conditions, and exclusion of alternative diagnoses. Nasal endoscopy and non-contrast computed tomography of the paranasal sinuses play complementary roles in confirming disease and planning treatment. Management aims to control inflammation, improve sinonasal function, reduce exacerbations, and restore quality of life. Saline nasal irrigation and intranasal corticosteroids constitute the foundation of medical treatment. Selected patients may benefit from short courses of systemic corticosteroids, appropriately indicated antimicrobial therapy, endoscopic sinus surgery, or biologic agents. Antibiotics should not be routinely prescribed for stable CRS, and antifungal therapy is not recommended for routine treatment. Biologic agents have expanded treatment options for selected patients with severe CRSwNP, particularly when conventional medical and surgical treatment has failed or surgery is unsuitable. This narrative review summarizes the contemporary understanding of CRS, including its pathophysiology, clinical classification, diagnostic evaluation, evidence-based medical and surgical management, emerging targeted therapies, complications, and future directions. An individualized, multidisciplinary approach remains essential for optimizing outcomes and minimizing unnecessary treatment.
Keywords	Chronic rhinosinusitis, nasal polyps, nasal endoscopy, computed tomography, intranasal corticosteroids, endoscopic sinus surgery, biologic therapy, evidence-based management.
Field	Medical / Pharmacy
Published In	Volume 4, Issue 6, November-December 2022
Published On	2022-11-18

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International Journal For Multidisciplinary Research

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Chronic Rhinosinusitis: Contemporary Diagnosis and Evidence-Based Management

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