Chronic Rhinosinusitis Management: A Narrative Review Comparing Interventional Treatment With Osteopathic Manipulation.

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nasal cavity and paranasal sinuses. Diagnosis of CRS typically requires two of the following four symptoms to persist for a minimum of 12 weeks: anterior or posterior nasal drainage, hyposmia or anosmia, facial pain or pressure, or nasal obstruction. Additionally, diagnosis necessitates the visualization of inflammation on physical examination or diagnostic imaging. This review aims to compare the outcomes of CRS patients who undergo interventional treatment via functional endoscopic sinus surgery (FESS) to those who opt for noninterventional treatment with osteopathic manipulation. FESS is not the sole interventional method utilized for CRS, but it is the focus of this review since it is the gold standard surgical treatment, encompassing a variety of techniques. Although there is limited literature discussing the use of osteopathic manipulative treatment (OMT) to remedy CRS, some evidence indicates OMT can alleviate symptoms for individuals seeking non-surgical alternatives. Moreover, osteopathic manipulation for CRS may be beneficial for patients unresponsive to previous medical or surgical management. Pharmacologic treatment is typically the initial approach to CRS and is discussed briefly herein, though it largely falls beyond the scope of this review.