Context

Chronic rhinosinusitis (CRS) affects between 7% and 15.5% of the US population. In Europe, the latest estimates put prevalence at 10.9%.1 ,2 The condition produces symptoms such as nasal congestion, facial pressure/pain, purulent nasal drainage and is associated with significant fatigue and decreased productivity. While complications from the disease are rare, CRS is often treated with antibiotics, based on an older understanding that CRS results from bacterial infection. Newer data strongly suggest that CRS results from chronic inflammation of the sinonasal mucosa.3 Among otolaryngologists, the treatment strategy has shifted towards the use of antiinflammatory medications, such as topical and systemic corticosteroids. Choosing the optimal, …