DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20223004
Published: 2022-11-28

Evaluation, complications and treatment of chronic rhinosinusitis

Omar Ali Khatab, Moataz Ali Bajaber, Nada Talal Alharbi, Naif Talal Alharbi, Nada Aouda Alshahrani, Nariman Ayman Fageeh, Ahmed Zuhair Salman, Samar Mohammed Al Omran, Amal Faleh Alshahrani, Abdulgader Jamal Mira, Faris Ayman Marouf

Abstract


Chronic rhinosinusitis (CRS) is a disease which commonly affects people of all ages and significantly impacts the quality of life. The clinical symptoms of CRS, which is defined by a chronic inflammation of the sinonasal mucosa, include persistent rhinorrhoea, nasal congestion, sinus pressure, and a diminished sense of smell that lasts longer than 12 weeks. CRS can be categorized into two groups: CRS with nasal polyps and CRS without nasal polyps. Inflammatory, environmental, and host factors are responsible for causing CRS although the mechanism is debatable. Diagnostic examination including anterior rhinoscopy, endoscopy or radiography, ideally from sinus computed tomography, can aid in confirmational diagnosis of CRS. The objective of the treatment is to improve mucociliary clearance, nasal drainage and outflow, reduce local infection and inflammation, and facilitate topical medicament access. Nasal saline irrigation and intranasal corticosteroid sprays are the first-line treatments. Antibiotics may be helpful for patients who have symptoms of a superimposed, acute active sinus infection. Endoscopic sinus surgery may be useful if medical therapy is ineffective. Referrals to otolaryngologists should be made for patients who are not responding to first-line medical therapy. CRS if not treated timely can further lead to complications including development of various diseases such as asthma breathing issues, smell disorders and certain bacterial and fungal infections. Effective treatment of the CRS is hence needed. The purpose of this research is to review the available information about evaluation, complications and treatment of CRS.


Keywords


Chronic, Rhinosinusitis, Nasal, Treatment

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References


Nirouei M, Sharif R, Sehat M, Rasouli SE, Fayyaz F, Heidarzadeh Arani M. Epidemiology and associated risk factors with allergic rhinitis, acute and chronic rhinosinusitis in Kashan. Revue Fran├žaise d'Allergologie. 2022.

Lam K, Schleimer R, Kern RC. The Etiology and Pathogenesis of Chronic Rhinosinusitis: a Review of Current Hypotheses. Curr Aller Asthma Rep. 2015;15(7):41.

Albu S. Chronic Rhinosinusitis-An Update on Epidemiology, Pathogenesis and Management. J Clin Med. 2020;9(7).

Tint D, Kubala S, Toskala E. Risk Factors and Comorbidities in Chronic Rhinosinusitis. Curr Aller Asthma Rep. 2016;16(2):16.

Smith SS, Kim R, Douglas R. Is there a role for antibiotics in the treatment of chronic rhinosinusitis? J Aller Clin Immunol. 2022;149(5):1504-12.

Hopkins C, Lee SE, Klimek L, Soler ZM. Clinical Assessment of Chronic Rhinosinusitis. J Allergy Clin Immunol Pract. 2022;10(6):1406-16.

Bernstein JA, White AA, Han JK, Lang DM, Elkayam D, Baroody FM. Review of evidence supporting the use of nasal corticosteroid irrigation for chronic rhinosinusitis. Ann Allergy, Asthma Immunol. 2022.

Sundaresan AS, Hirsch AG, Young AJ. Longitudinal Evaluation of Chronic Rhinosinusitis Symptoms in a Population-Based Sample. J Allergy Clin Immunol Pract. 2018;6(4):1327-35.

Stevens WW, Lee RJ, Schleimer RP, Cohen NA. Chronic rhinosinusitis pathogenesis. J Allergy Clin Immunol. 2015;136(6):1442-53.

Marple BF, Stankiewicz JA, Baroody FM. Diagnosis and management of chronic rhinosinusitis in adults. Postgraduate Med. 2009;121(6):121-39.

Bhattacharyya N. Clinical and symptom criteria for the accurate diagnosis of chronic rhinosinusitis. Laryngoscope. 2006;116(7 Pt 2-110):1-22.

Jiang N, Kern RC, Altman KW. Histopathological evaluation of chronic rhinosinusitis: a critical review. Am J Rhinol Allergy. 2013;27(5):396-402.

Schlosser RJ, Soler ZM. Evidence-based treatment of chronic rhinosinusitis with nasal polyps. Am J Rhinol Allergy. 2013;27(6):461-6.

Cazzavillan A, Castelnuovo P, Berlucchi M. Management of chronic rhinosinusitis. Pediatric Allergy Immunol. 2012;23(22):32-44.

Guilemany JM, Alobid I, Mullol J. Controversies in the treatment of chronic rhinosinusitis. Expert Rev Respiratory Med. 2010;4(4):463-77.

Walker A, Philpott C, Hopkins C. What is the most appropriate treatment for chronic rhinosinusitis? Postgraduate Med J. 2019;95(1127):493-6.

Beswick DM, Gray ST, Smith TL. Pharmacological Management of Chronic Rhinosinusitis: Current and Evolving Treatments. Drugs. 2017;77(16):1713-21.

Schwartz JS, Tajudeen BA, Cohen NA. Medical management of chronic rhinosinusitis-a review of traditional and novel medical therapies. Expert Opinion Investigational Drugs. 2017;26(10):1123-30.

Patel GB, Kern RC, Bernstein JA, Hae-Sim P, Peters AT. Current and Future Treatments of Rhinitis and Sinusitis. The journal of allergy and clinical immunology In practice. 2020;8(5):1522-31.

Carr TF. Complications of sinusitis. Am J Rhinol Allergy. 2016;30(4):241-5.

Lee WH, Kim JW, Lim JS, Kong IG, Choi HG. Chronic rhinosinusitis increases the risk of hemorrhagic and ischemic stroke: A longitudinal follow-up study using a national sample cohort. PloS one. 2018;13(3):e0193886.

Kim JY, Ko I, Kim MS, Yu MS, Cho BJ, Kim DK. Association of Chronic Rhinosinusitis With Depression and Anxiety in a Nationwide Insurance Population. JAMA Otolaryngol Head Neck Surg. 2019;145(4):313-9.

Hirsch AG, Yan XS, Sundaresan AS. Five-year risk of incident disease following a diagnosis of chronic rhinosinusitis. Allergy. 2015;70(12):1613-21.