Severity and Treatment Outcome Based on Phenotypes and Endotypes Classifications of Chronic Rhinosinusitis

Chronic rhinosinusitis is one of the most common chronic diseases with multi-factorial origin and different underlying pathophysiologies that has a great impact on quality of life with. It is generally agreed that there are many subgroups or “phenotypes” of chronic rhinosinusitis defined by clinical observable characteristics, such as the presence or absence of nasal polyps. These phenotypes are useful for therapeutic decision. However, it doesn’t provide complete understanding about all underlying cellular and molecular pathophysiologic mechanisms of this pathology. The concept of multiple groups of biological subtypes, or ‘‘endotypes’’ which are identified by corresponding biomarkers has been recently studied. Classification of chronic rhinosinusitis according to phenotypes and endotypes may allow the identification of subgroups in relation to treatment response. Better identification of phenotypes and especially endotypes may improve individualization of therapy that can be targeted against specific biomarkers as recently developed, such as anti-IL-5 and anti-IgE. Literature review is essential for better developing general classification of chronic rhinosinusitis and better prediction of treatment outcome.