Evaluation and Management of Adult Chronic Rhinosinusitis

Chronic rhinosinusitis (CRS) is a common disease affecting up to 12.5% of the adult population in America, approximately 31 million people [1]. Based on sheer numbers, the disease greatly impacts the health care system and the national economy as a whole. One survey found that over 22 million office visits per year in the United States are related to a CRS diagnosis [2]. In 1996 alone, national health care expenditures attributable to CRS were estimated at $3.39 billion, spent on office visits, medications, and surgical treatments [3]. Indirect costs were even greater at $5.8 billion due to 12.5 million lost workdays and 58.7 million restricted workdays [3,4]. On an individual level, this amounts to $921 in costs and 4.8 lost workdays per patient-year [5]. Current controversies regarding CRS revolve around the definition, diagnosis, and treatment. National multispecialty committees have convened to standardize diagnostic criteria and formulate an approach to treatment with a focus on evidence-based management [6,7]. Research efforts focus on identifying the underlying pathophysiology with the hope of tailoring treatment.