Optimal Strategies in Medical Management of Frontal Sinusitis
Chronic rhinosinusitis (CRS) is an inflammatory condition of the sinonasal passages. Medical therapy is an essential component in the management of CRS and is often necessary for successful long-term symptom control and the control of disease recurrence. The primary goal of medical therapy is to reduce sinonasal mucosal inflammation. The frontal sinus is the most complex sinus to manage in patients with CRS, in part due to its challenging anatomy and difficulty of delivering topical anti-inflammatory medications through the frontal recess due the presence of variable and complex frontal cells, which may partially or completely obstruct the frontal recess. While endoscopic sinus surgery (ESS) may improve the delivery of medication to the frontal recess, stenosis and disease recurrence are common, and prolonged medical therapy is often required. A variety of medical therapies are currently available for the management of CRS, and many innovative therapies are currently being investigated. Understanding the different types of therapies available, as well as the evidence and role for these therapies, is essential to aid clinicians in managing frontal sinusitis. The objective of this chapter is to review the available medical therapies, the most up-to-date evidence for these therapies, and their role in the management of frontal sinusitis.
KeywordsChronic rhinosinusitis Sinusitis Frontal Medical therapy Nasal polyposis
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