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Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis

Daniel L Hamilos, MD
Section Editors
Jonathan Corren, MD
Daniel G Deschler, MD, FACS
Deputy Editor
Anna M Feldweg, MD


Chronic rhinosinusitis (CRS) may be broadly defined as an inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer. More precisely, it is a heterogeneous group of related disorders that share certain clinical and pathologic features. In the past, CRS lacked a clear definition and was approached differently by various specialties. However, multidisciplinary expert panels have been established to determine how these disorders should be defined, evaluated, and managed [1-5].

The definition, epidemiology, clinical manifestations, pathologic features, evaluation, and diagnosis of CRS will be discussed here. Treatment is presented separately. The complex role of microbes and antimicrobial therapy in CRS is reviewed elsewhere. (See "Chronic rhinosinusitis: Management" and "Microbiology and antibiotic management of chronic rhinosinusitis".)


Chronic rhinosinusitis (CRS) is defined as an inflammatory condition involving the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer. The diagnosis requires objective evidence of mucosal inflammation.

In some iterations of the definition, the phrase "despite attempts at medical management" is included to eliminate the possibility that CRS simply represents untreated acute rhinosinusitis. However, it is problematic to include this phrase, since there is no definitive standard of treatment [2-6].

Current definitions differ from earlier definitions of "chronic sinusitis" by adopting the term "rhinosinusitis" to emphasize the involvement of both the nasal passages and the paranasal sinuses, and by requiring objective evidence of sinus mucosal disease [1,6,7].

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Literature review current through: Oct 2017. | This topic last updated: Oct 28, 2016.
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