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Chronic Rhinosinusitis and Nasal Polyposis

  • Leslie C. Grammer
Living reference work entry

Abstract

Chronic rhinosinusitis (CRS) is a common disease, affecting up to 10% of the population at some time. Symptoms alone do not define the disease; objective evidence of inflammation by nasal endoscopy and/or sinus CT scan is also required. In the USA alone, the estimated annual direct and indirect costs exceed $30 billion. There are two subtypes, depending upon whether nasal polyps (NP) are present: CRSw(with)NP and CRSs(without)NP. A variety of risk factors and comorbidities have been described; in most cases, an aeroallergen evaluation should be performed, and, in recalcitrant cases, an immunodeficiency evaluation should be considered. The pathogenesis is unclear; a variety of factors have been implicated as contributory. They include impaired antimicrobial responses, ciliary abnormalities, epithelial dysfunction, microbial dysbiosis, autoantibodies, and S. aureus enterotoxins acting as allergens and/or superantigens. Maximal medical therapy, often including corticosteroids, antibiotics, and saline irrigations, is the initial treatment. Only those who fail are considered for surgical treatment.

Keywords

Chronic rhinosinusitis Nasal polyps Aspirin-exacerbated respiratory disease Antibody deficiency 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Allergy-Immunology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoUSA

Section editors and affiliations

  • Massoud Mahmoudi
    • 1
  • Dennis K. Ledford
    • 2
  1. 1.Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.Division of Allergy & Immunology, Dept. of Internal MedicineUniversity of South Florida Morsani College of Medicine, James A Haley Veterans' Hospital, Asthma and Immunology Associates of Tampa BayTampaUSA

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