Chronic Rhinosinusitis: Adults and Children

Abstract

Chronic rhinosinusitis (CRS) could be briefly defined as a mucosal inflammation of the nasal cavity and paranasal sinuses that lasts 12 weeks or longer. Rhinosinusitis is the preferred term rather than using the phrase “sinusitis” as the inflammation of paranasal sinuses and the nasal cavity is almost always seen together. It is not a result of a single pathologic condition but more precisely should be seen as a combination of related disorders those have common clinical and histologic findings. Exact definition of CRS has been a controversial issue for many years. Many different classifications and management algorithms have been reported in the literature in order to standardize the whole process. CRS cannot be simplified as an untreated or persistant acute rhinosinusitis; therefore, the diagnosis should be based on objective evidence of chronic mucosal inflammation. Prevelance of CRS varies worldwide due to different diagnostic criteria of the disease. In many countries, it ranges from 7 to 27% due to subjective symptom-based diagnosis of the disease. Chronic rhinosinusitis is a clinical condition resulting from heterogenous group of disorders. In order to evaluate and manage the process, it is subclassified into three groups: (1) CRS with Nasal Polyposis, (2) CRS without Nasal Polyposis and (3) Allergic Fungal Rhinosinusitis. In this chapter, CRS is discussed.