Surgical Management of Rhinosinusitus for the Allergist-Immunologist

Ann Allergy Asthma Immunol. 2023 May 21:S1081-1206(23)00357-5. doi: 10.1016/j.anai.2023.05.015. Online ahead of print.ABSTRACTChronic rhinosinusitis (CRS) is a common chronic inflammatory disease characterized by inflammation of the sinus with or without nasal passage inflammation occurring for more than 12 weeks at a time. CRS is historically categorized into two categories: chronic sinusitis without nasal polyps (CRSsNP) or chronic sinusitis with nasal polyps (CRSwNP ∼ 25%-30% of cases). The mainstay of treatment for CRS with or without nasal polyps is medical management and options may include a combination of saline irrigation, nasal steroids, allergy medications, antibiotics, oral steroids, inhaled steroids and/or treatment with targeted monoclonal antibodies. Unfortunately, up to 60% of patents report symptoms refractory to maximal medical therapy. As such, a combined approach of surgery and medical therapy may be offered. Endoscopic sinus surgery for CRS is approached in a stepwise fashion, ranging from the most simple technique, such as polyp removal, to more expanded approaches that open the paranasal sinuses and allow for gravity dependent drainage. This review article provides a review and in depth explanation of various surgical approaches for CRS, including the indications, techniques and respective outcomes for each one.PMID:37220810 | DOI:10.1016/j.anai.2023.05.015
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research