Allergy Asthma Immunol Res.  2011 Oct;3(4):226-235. 10.4168/aair.2011.3.4.226.

Chronic Rhinosinusitis: Therapeutic Efficacy of Anti-Inflammatory and Antibiotic Approaches

• Kariyawasam HH
• Scadding G

• KMID: 2167073
• DOI: http://doi.org/10.4168/aair.2011.3.4.226

Abstract

Despite the high prevalence of chronic rhinosinusitis (CRS) worldwide, the exact pathogenesis of the disease remains unknown. Even with therapeutic intervention, treatment response is often only partial and frequently ineffective. The inability to define exact disease phenotypes in relation to specific disease mechanisms has led to a broad based approach with both anti-inflammatory and anti-microbial intervention. The clinical efficacy of such current therapeutic strategies is highlighted and the urgent need for further robust therapeutic intervention studies in CRS is discussed in this article.

Keyword

Rhinosinusitis; anti-inflammatory, antibiotics

MeSH Terms

Clinical Trial
Phenotype
Prevalence

Figure

• 

  Figure Summary of therapeutic approaches to chronic rhinosinusitis. Chronic rhinosinusitis (CRS) can be broadly divided into CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP). Further phenotyping of disease to identify exacerbating co-factors or distinct forms of disease such as immunodeficiency, aspirin sensitivity or vasculitis is needed, in to order to appropriately guide therapy. The approach with nasal douching, steroid therapy and antibiotics can often benefit most forms of CRS, but different subtypes are more responsive than others. Particularly individuals with aspirin sensitivity may benefit from leukotriene receptor inhibition and intranasal aspirin desensitisation. Surgical correction of anatomical abnormalities that may predispose to exacerbation should be addressed.

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