UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Chronic rhinosinusitis: Management

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

INTRODUCTION

Chronic rhinosinusitis (CRS) is defined as an inflammatory condition involving the paranasal sinuses and linings of the nasal passages, which persists for 12 weeks or longer [1-5].

There are four cardinal signs/symptoms of CRS:

Anterior and/or posterior mucopurulent drainage

Nasal obstruction

Facial pain, pressure, and/or fullness

                                                    

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Mon Aug 01 00:00:00 GMT+00:00 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Scadding GK, Durham SR, Mirakian R, et al. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy 2008; 38:260.
  2. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 2015; 152:S1.
  3. Fokkens W, Lund V, Mullol J, European Position Paper on Rhinosinusitis and Nasal Polyps Group. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists. Rhinology 2007; 45:97.
  4. Slavin RG, Spector SL, Bernstein IL, et al. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol 2005; 116:S13.
  5. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997; 117:S1.
  6. Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004; 114:155.
  7. Bassiouni A, Naidoo Y, Wormald PJ. Does mucosal remodeling in chronic rhinosinusitis result in irreversible mucosal disease? Laryngoscope 2012; 122:225.
  8. Ragab SM, Lund VJ, Scadding G. Evaluation of the medical and surgical treatment of chronic rhinosinusitis: a prospective, randomised, controlled trial. Laryngoscope 2004; 114:923.
  9. Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. Mayo Clin Proc 2011; 86:427.
  10. Mafee MF. Imaging of paranasal sinuses and rhinosinusitis. Clin Allergy Immunol 2007; 20:185.
  11. Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 2006; 118:S17.
  12. Chong LY, Head K, Hopkins C, et al. Saline irrigation for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011995.
  13. Chong LY, Head K, Hopkins C, et al. Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011996.
  14. Chong LY, Head K, Hopkins C, et al. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011993.
  15. Head K, Chong LY, Piromchai P, et al. Systemic and topical antibiotics for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011994.
  16. Head K, Chong LY, Hopkins C, et al. Short-course oral steroids alone for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011991.
  17. Head K, Chong LY, Hopkins C, et al. Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis. Cochrane Database Syst Rev 2016; 4:CD011992.
  18. Adappa ND, Wei CC, Palmer JN. Nasal irrigation with or without drugs: the evidence. Curr Opin Otolaryngol Head Neck Surg 2012; 20:53.
  19. Pynnonen MA, Mukerji SS, Kim HM, et al. Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Arch Otolaryngol Head Neck Surg 2007; 133:1115.
  20. Wormald PJ, Cain T, Oates L, et al. A comparative study of three methods of nasal irrigation. Laryngoscope 2004; 114:2224.
  21. Keen M, Foreman A, Wormald PJ. The clinical significance of nasal irrigation bottle contamination. Laryngoscope 2010; 120:2110.
  22. Chiu AG, Palmer JN, Woodworth BA, et al. Baby shampoo nasal irrigations for the symptomatic post-functional endoscopic sinus surgery patient. Am J Rhinol 2008; 22:34.
  23. Isaacs S, Fakhri S, Luong A, et al. The effect of dilute baby shampoo on nasal mucociliary clearance in healthy subjects. Am J Rhinol Allergy 2011; 25:e27.
  24. Fokkens W, Lund V, Bachert C, et al. EAACI position paper on rhinosinusitis and nasal polyps executive summary. Allergy 2005; 60:583.
  25. Benítez P, Alobid I, de Haro J, et al. A short course of oral prednisone followed by intranasal budesonide is an effective treatment of severe nasal polyps. Laryngoscope 2006; 116:770.
  26. Parikh A, Scadding GK, Darby Y, Baker RC. Topical corticosteroids in chronic rhinosinusitis: a randomized, double-blind, placebo-controlled trial using fluticasone propionate aqueous nasal spray. Rhinology 2001; 39:75.
  27. Lavigne F, Cameron L, Renzi PM, et al. Intrasinus administration of topical budesonide to allergic patients with chronic rhinosinusitis following surgery. Laryngoscope 2002; 112:858.
  28. Lund VJ, Black JH, Szabó LZ, et al. Efficacy and tolerability of budesonide aqueous nasal spray in chronic rhinosinusitis patients. Rhinology 2004; 42:57.
  29. Rudmik L, Soler ZM. Medical Therapies for Adult Chronic Sinusitis: A Systematic Review. JAMA 2015; 314:926.
  30. Hardy JG, Lee SW, Wilson CG. Intranasal drug delivery by spray and drops. J Pharm Pharmacol 1985; 37:294.
  31. Aukema AA, Mulder PG, Fokkens WJ. Treatment of nasal polyposis and chronic rhinosinusitis with fluticasone propionate nasal drops reduces need for sinus surgery. J Allergy Clin Immunol 2005; 115:1017.
  32. Hamilos DL. Approach to the evaluation and medical management of chronic rhinosinusitis. Clin Allergy Immunol 2007; 20:299.
  33. Harvey RJ, Debnath N, Srubiski A, et al. Fluid residuals and drug exposure in nasal irrigation. Otolaryngol Head Neck Surg 2009; 141:757.
  34. Rotenberg BW, Zhang I, Arra I, Payton KB. Postoperative care for Samter's triad patients undergoing endoscopic sinus surgery: a double-blinded, randomized controlled trial. Laryngoscope 2011; 121:2702.
  35. Sachanandani NS, Piccirillo JF, Kramper MA, et al. The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg 2009; 135:303.
  36. Wang C, Lou H, Wang X, et al. Effect of budesonide transnasal nebulization in patients with eosinophilic chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol 2015; 135:922.
  37. Scheinberg PA, Otsuji A. Nebulized antibiotics for the treatment of acute exacerbations of chronic rhinosinusitis. Ear Nose Throat J 2002; 81:648.
  38. Vaughan WC, Carvalho G. Use of nebulized antibiotics for acute infections in chronic sinusitis. Otolaryngol Head Neck Surg 2002; 127:558.
  39. Lim M, Citardi MJ, Leong JL. Topical antimicrobials in the management of chronic rhinosinusitis: a systematic review. Am J Rhinol 2008; 22:381.
  40. Lee JT, Chiu AG. Topical anti-infective sinonasal irrigations: update and literature review. Am J Rhinol Allergy 2014; 28:29.
  41. Jervis-Bardy J, Boase S, Psaltis A, et al. A randomized trial of mupirocin sinonasal rinses versus saline in surgically recalcitrant staphylococcal chronic rhinosinusitis. Laryngoscope 2012; 122:2148.
  42. Elliott KA, Stringer SP. Evidence-based recommendations for antimicrobial nasal washes in chronic rhinosinusitis. Am J Rhinol 2006; 20:1.
  43. Whatley WS, Chandra RK, MacDonald CB. Systemic absorption of gentamicin nasal irrigations. Am J Rhinol 2006; 20:251.
  44. Cheng AG, Johnston PR, Luz J, et al. Sensorineural hearing loss in patients with cystic fibrosis. Otolaryngol Head Neck Surg 2009; 141:86.
  45. Pauli C, Fintelmann R, Klemens C, et al. [Polyposis nasi--improvement in quality of life by the influence of leukotrien receptor antagonists]. Laryngorhinootologie 2007; 86:282.
  46. Schäper C, Noga O, Koch B, et al. Anti-inflammatory properties of montelukast, a leukotriene receptor antagonist in patients with asthma and nasal polyposis. J Investig Allergol Clin Immunol 2011; 21:51.
  47. Wentzel JL, Soler ZM, DeYoung K, et al. Leukotriene antagonists in nasal polyposis: a meta-analysis and systematic review. Am J Rhinol Allergy 2013; 27:482.
  48. Kieff DA, Busaba NY. Efficacy of montelukast in the treatment of nasal polyposis. Ann Otol Rhinol Laryngol 2005; 114:941.
  49. Mostafa BE, Abdel Hay H, Mohammed HE, Yamani M. Role of leukotriene inhibitors in the postoperative management of nasal polyps. ORL J Otorhinolaryngol Relat Spec 2005; 67:148.
  50. Weschta M, Rimek D, Formanek M, et al. Topical antifungal treatment of chronic rhinosinusitis with nasal polyps: a randomized, double-blind clinical trial. J Allergy Clin Immunol 2004; 113:1122.
  51. Kennedy DW, Kuhn FA, Hamilos DL, et al. Treatment of chronic rhinosinusitis with high-dose oral terbinafine: a double blind, placebo-controlled study. Laryngoscope 2005; 115:1793.
  52. Ponikau JU, Sherris DA, Weaver A, Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: a randomized, placebo-controlled, double-blind pilot trial. J Allergy Clin Immunol 2005; 115:125.
  53. Ebbens FA, Scadding GK, Badia L, et al. Amphotericin B nasal lavages: not a solution for patients with chronic rhinosinusitis. J Allergy Clin Immunol 2006; 118:1149.
  54. Helbling A, Baumann A, Hänni C, Caversaccio M. Amphotericin B nasal spray has no effect on nasal polyps. J Laryngol Otol 2006; 120:1023.
  55. Weschta M, Rimek D, Formanek M, et al. Effect of nasal antifungal therapy on nasal cell activation markers in chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg 2006; 132:743.
  56. Sacks PL, Harvey RJ, Rimmer J, et al. Topical and systemic antifungal therapy for the symptomatic treatment of chronic rhinosinusitis. Cochrane Database Syst Rev 2011; :CD008263.
  57. Sacks PL 4th, Harvey RJ, Rimmer J, et al. Antifungal therapy in the treatment of chronic rhinosinusitis: a meta-analysis. Am J Rhinol Allergy 2012; 26:141.
  58. Rotenberg BW, Bertens KA. Use of complementary and alternative medical therapies for chronic rhinosinusitis: a canadian perspective. J Otolaryngol Head Neck Surg 2010; 39:586.
  59. Yakirevitch A, Bedrin L, Migirov L, et al. Use of alternative medicine in Israeli chronic rhinosinusitis patients. J Otolaryngol Head Neck Surg 2009; 38:517.
  60. Suh JD, Wu AW, Taw MB, et al. Treatment of recalcitrant chronic rhinosinusitis with integrative East-West medicine: a pilot study. Arch Otolaryngol Head Neck Surg 2012; 138:294.
  61. Helms S, Miller A. Natural treatment of chronic rhinosinusitis. Altern Med Rev 2006; 11:196.
  62. Friedman M, Hamilton C, Samuelson CG, et al. Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study. Int Forum Allergy Rhinol 2012; 2:252.
  63. Jiang RS, Wu SH, Tsai CC, et al. Efficacy of Chinese herbal medicine compared with a macrolide in the treatment of chronic rhinosinusitis without nasal polyps. Am J Rhinol Allergy 2012; 26:293.
  64. Cherry WB, Li JT. Chronic rhinosinusitis in adults. Am J Med 2008; 121:185.
  65. Ozturk F, Bakirtas A, Ileri F, Turktas I. Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial. J Allergy Clin Immunol 2011; 128:348.
  66. Subramanian HN, Schechtman KB, Hamilos DL. A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 2002; 16:303.
  67. Skorpinski EW, Vannelli PM, Yousef E, et al. Radiologic outcomes in children with chronic rhinosinusitis and ostiomeatal complex obstruction after medical management. Ann Allergy Asthma Immunol 2008; 100:529.
  68. Jiang RS, Su MC, Liao CY, Lin JF. Bacteriology of chronic sinusitis in relation to middle meatal secretion. Am J Rhinol 2006; 20:173.
  69. Uhliarova B, Karnisova R, Svec M, Calkovska A. Correlation between culture-identified bacteria in the middle nasal meatus and CT score in patients with chronic rhinosinusitis. J Med Microbiol 2014; 63:28.
  70. Ikeda K, Ono N, Iizuka T, et al. Bacteriologic evaluation of sinus aspirates taken by balloon catheter devices in chronic rhinosinusitis: preliminary study. ORL J Otorhinolaryngol Relat Spec 2011; 73:271.
  71. Wallwork B, Coman W, Mackay-Sim A, et al. A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis. Laryngoscope 2006; 116:189.
  72. Hashiba M, Baba S. Efficacy of long-term administration of clarithromycin in the treatment of intractable chronic sinusitis. Acta Otolaryngol Suppl 1996; 525:73.
  73. Tatar EÇ, Tatar I, Ocal B, et al. Prevalence of biofilms and their response to medical treatment in chronic rhinosinusitis without polyps. Otolaryngol Head Neck Surg 2012; 146:669.
  74. Zeng M, Long XB, Cui YH, Liu Z. Comparison of efficacy of mometasone furoate versus clarithromycin in the treatment of chronic rhinosinusitis without nasal polyps in Chinese adults. Am J Rhinol Allergy 2011; 25:e203.
  75. Videler WJ, Badia L, Harvey RJ, et al. Lack of efficacy of long-term, low-dose azithromycin in chronic rhinosinusitis: a randomized controlled trial. Allergy 2011; 66:1457.
  76. Haxel BR, Clemens M, Karaiskaki N, et al. Controlled trial for long-term low-dose erythromycin after sinus surgery for chronic rhinosinusitis. Laryngoscope 2015; 125:1048.
  77. Kane KJ. Recirculation of mucus as a cause of persistent sinusitis. Am J Rhinol 1997; 11:361.
  78. Richtsmeier WJ. Top 10 reasons for endoscopic maxillary sinus surgery failure. Laryngoscope 2001; 111:1952.
  79. Tichenor WS, Adinoff A, Smart B, Hamilos DL. Nasal and sinus endoscopy for medical management of resistant rhinosinusitis, including postsurgical patients. J Allergy Clin Immunol 2008; 121:917.
  80. Matthews BL, Burke AJ. Recirculation of mucus via accessory ostia causing chronic maxillary sinus disease. Otolaryngol Head Neck Surg 1997; 117:422.
  81. Yanagisawa E, Yanagisawa K. Endoscopic view of recirculation phenomenon of the maxillary sinus. Ear Nose Throat J 1997; 76:196.
  82. Yanagisawa E, Weaver EM. Endoscopic view of the recirculation phenomenon of sphenoid sinus drainage. Ear Nose Throat J 1996; 75:68.
  83. Gutman M, Houser S. Iatrogenic maxillary sinus recirculation and beyond. Ear Nose Throat J 2003; 82:61.
  84. Patel A, deShazo RD, Stringer S. Diagnostic criteria for a curable form of chronic rhinosinusitis: the mucous recirculation syndrome. Am J Med 2014; 127:586.
  85. Schlenter WW, Mann WJ. [Operative therapy in chronic sinusitis - results in allergic and nonallergic patients]. Laryngol Rhinol Otol (Stuttg) 1983; 62:284.
  86. DeYoung K, Wentzel JL, Schlosser RJ, et al. Systematic review of immunotherapy for chronic rhinosinusitis. Am J Rhinol Allergy 2014; 28:145.
  87. Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012; :3 p preceding table of contents, 1.
  88. Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs 2007; 67:887.
  89. Alobid I, Benitez P, Pujols L, et al. Severe nasal polyposis and its impact on quality of life. The effect of a short course of oral steroids followed by long-term intranasal steroid treatment. Rhinology 2006; 44:8.
  90. Hissaria P, Smith W, Wormald PJ, et al. Short course of systemic corticosteroids in sinonasal polyposis: a double-blind, randomized, placebo-controlled trial with evaluation of outcome measures. J Allergy Clin Immunol 2006; 118:128.
  91. Van Zele T, Gevaert P, Holtappels G, et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol 2010; 125:1069.
  92. Bülbül T, Bülbül OG, Güçlü O, et al. Effect of glucocorticoids on nasal polyposis, with detection of inflammatory response by measurement of nitric oxide levels in nasal polyp tissue. J Laryngol Otol 2013; 127:584.
  93. Vaidyanathan S, Barnes M, Williamson P, et al. Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med 2011; 154:293.
  94. Fernandes AM, Valera FC, Anselmo-Lima WT. Mechanism of action of glucocorticoids in nasal polyposis. Braz J Otorhinolaryngol 2008; 74:279.
  95. Wen W, Liu W, Zhang L, et al. Increased neutrophilia in nasal polyps reduces the response to oral corticosteroid therapy. J Allergy Clin Immunol 2012; 129:1522.
  96. Sharma R, Lakhani R, Rimmer J, Hopkins C. Surgical interventions for chronic rhinosinusitis with nasal polyps. Cochrane Database Syst Rev 2014; :CD006990.
  97. Schalek P, Petrás P, Klement V, Hahn A. Short-term antibiotics treatment in patients with nasal polyps and enterotoxins producing Staphylococcus aureus strains. Eur Arch Otorhinolaryngol 2009; 266:1909.
  98. Bachert C, Watelet JB, Gevaert P, Van Cauwenberge P. Pharmacological management of nasal polyposis. Drugs 2005; 65:1537.
  99. Small CB, Hernandez J, Reyes A, et al. Efficacy and safety of mometasone furoate nasal spray in nasal polyposis. J Allergy Clin Immunol 2005; 116:1275.
  100. Stjärne P, Olsson P, Alenius M. Use of mometasone furoate to prevent polyp relapse after endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 2009; 135:296.
  101. Dijkstra MD, Ebbens FA, Poublon RM, Fokkens WJ. Fluticasone propionate aqueous nasal spray does not influence the recurrence rate of chronic rhinosinusitis and nasal polyps 1 year after functional endoscopic sinus surgery. Clin Exp Allergy 2004; 34:1395.
  102. Ragab S, Parikh A, Darby YC, Scadding GK. An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma. Clin Exp Allergy 2001; 31:1385.
  103. Stewart RA, Ram B, Hamilton G, et al. Montelukast as an adjunct to oral and inhaled steroid therapy in chronic nasal polyposis. Otolaryngol Head Neck Surg 2008; 139:682.
  104. Micheletto C, Tognella S, Visconti M, et al. Montelukast 10 mg improves nasal function and nasal response to aspirin in ASA-sensitive asthmatics: a controlled study vs placebo. Allergy 2004; 59:289.
  105. Haye R, Aanesen JP, Burtin B, et al. The effect of cetirizine on symptoms and signs of nasal polyposis. J Laryngol Otol 1998; 112:1042.
  106. Gevaert P, Calus L, Van Zele T, et al. Omalizumab is effective in allergic and nonallergic patients with nasal polyps and asthma. J Allergy Clin Immunol 2013; 131:110.
  107. Gevaert P, Van Bruaene N, Cattaert T, et al. Mepolizumab, a humanized anti-IL-5 mAb, as a treatment option for severe nasal polyposis. J Allergy Clin Immunol 2011; 128:989.
  108. Bachert C, Mannent L, Naclerio RM, et al. Effect of Subcutaneous Dupilumab on Nasal Polyp Burden in Patients With Chronic Sinusitis and Nasal Polyposis: A Randomized Clinical Trial. JAMA 2016; 315:469.
  109. Lumry WR, Curd JG, Zeiger RS, et al. Aspirin-sensitive rhinosinusitis: the clinical syndrome and effects of aspirin administration. J Allergy Clin Immunol 1983; 71:580.
  110. Schapowal AG, Simon HU, Schmitz-Schumann M. Phenomenology, pathogenesis, diagnosis and treatment of aspirin-sensitive rhinosinusitis. Acta Otorhinolaryngol Belg 1995; 49:235.
  111. Gosepath J, Schaefer D, Amedee RG, Mann WJ. Individual monitoring of aspirin desensitization. Arch Otolaryngol Head Neck Surg 2001; 127:316.
  112. Rozsasi A, Polzehl D, Deutschle T, et al. Long-term treatment with aspirin desensitization: a prospective clinical trial comparing 100 and 300 mg aspirin daily. Allergy 2008; 63:1228.
  113. Świerczyńska-Krępa M, Sanak M, Bochenek G, et al. Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: a double-blind study. J Allergy Clin Immunol 2014; 134:883.
  114. Lee JY, Simon RA, Stevenson DD. Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 2007; 119:157.
  115. Ogata N, Darby Y, Scadding G. Intranasal lysine-aspirin administration decreases polyp volume in patients with aspirin-intolerant asthma. J Laryngol Otol 2007; 121:1156.
  116. Hamilos DL. Chronic rhinosinusitis patterns of illness. Clin Allergy Immunol 2007; 20:1.
  117. Bassichis BA, Marple BF, Mabry RL, et al. Use of immunotherapy in previously treated patients with allergic fungal sinusitis. Otolaryngol Head Neck Surg 2001; 125:487.
  118. Gosepath J, Pogodsky T, Mann WJ. Characteristics of recurrent chronic rhinosinusitis after previous surgical therapy. Acta Otolaryngol 2008; 128:778.
  119. Li Y, Zhang GH, Liu X, et al. Clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery. ORL J Otorhinolaryngol Relat Spec 2008; 70:113.
  120. Khalil HS, Nunez DA. Functional endoscopic sinus surgery for chronic rhinosinusitis. Cochrane Database Syst Rev 2006; :CD004458.
  121. Kennedy DW. Prognostic factors, outcomes and staging in ethmoid sinus surgery. Laryngoscope 1992; 102:1.
  122. Senior BA, Kennedy DW, Tanabodee J, et al. Long-term results of functional endoscopic sinus surgery. Laryngoscope 1998; 108:151.
  123. Senior BA, Kennedy DW, Tanabodee J, et al. Long-term impact of functional endoscopic sinus surgery on asthma. Otolaryngol Head Neck Surg 1999; 121:66.
  124. The American Academy of Otolaryngology-Head and Neck Surgery website. http://www.entnet.org/Practice/Balloon-Dilation.cfm (Accessed on November 07, 2013).
  125. Ahmed J, Pal S, Hopkins C, Jayaraj S. Functional endoscopic balloon dilation of sinus ostia for chronic rhinosinusitis. Cochrane Database Syst Rev 2011; :CD008515.
  126. Stankiewicz J, Tami T, Truitt T, et al. Transantral, endoscopically guided balloon dilatation of the ostiomeatal complex for chronic rhinosinusitis under local anesthesia. Am J Rhinol Allergy 2009; 23:321.
  127. Weiss RL, Church CA, Kuhn FA, et al. Long-term outcome analysis of balloon catheter sinusotomy: two-year follow-up. Otolaryngol Head Neck Surg 2008; 139:S38.
  128. Cutler J, Bikhazi N, Light J, et al. Standalone balloon dilation versus sinus surgery for chronic rhinosinusitis: a prospective, multicenter, randomized, controlled trial. Am J Rhinol Allergy 2013; 27:416.
  129. Bikhazi N, Light J, Truitt T, et al. Standalone balloon dilation versus sinus surgery for chronic rhinosinusitis: a prospective, multicenter, randomized, controlled trial with 1-year follow-up. Am J Rhinol Allergy 2014; 28:323.
  130. Coticchia J, Zuliani G, Coleman C, et al. Biofilm surface area in the pediatric nasopharynx: Chronic rhinosinusitis vs obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2007; 133:110.
  131. Brietzke SE, Brigger MT. Adenoidectomy outcomes in pediatric rhinosinusitis: a meta-analysis. Int J Pediatr Otorhinolaryngol 2008; 72:1541.
  132. Makary CA, Ramadan HH. The role of sinus surgery in children. Laryngoscope 2013; 123:1348.
  133. Ramadan HH, McLaughlin K, Josephson G, et al. Balloon catheter sinuplasty in young children. Am J Rhinol Allergy 2010; 24:e54.
  134. Ramadan HH, Terrell AM. Balloon catheter sinuplasty and adenoidectomy in children with chronic rhinosinusitis. Ann Otol Rhinol Laryngol 2010; 119:578.
  135. Thottam PJ, Haupert M, Saraiya S, et al. Functional endoscopic sinus surgery (FESS) alone versus balloon catheter sinuplasty (BCS) and ethmoidectomy: a comparative outcome analysis in pediatric chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol 2012; 76:1355.
  136. Sedaghat AR, Cunningham MJ. Does balloon catheter sinuplasty have a role in the surgical management of pediatric sinus disease? Laryngoscope 2011; 121:2053.
  137. More Y, Willen S, Catalano P. Management of early nasal polyposis using a steroid-impregnated nasal dressing. Int Forum Allergy Rhinol 2011; 1:401.
  138. Hong SD, Kim JH, Dhong HJ, et al. Systemic effects and safety of triamcinolone-impregnated nasal packing after endoscopic sinus surgery: a randomized, double-blinded, placebo-controlled study. Am J Rhinol Allergy 2013; 27:407.
  139. Murr AH, Smith TL, Hwang PH, et al. Safety and efficacy of a novel bioabsorbable, steroid-eluting sinus stent. Int Forum Allergy Rhinol 2011; 1:23.
  140. Forwith KD, Chandra RK, Yun PT, et al. ADVANCE: a multisite trial of bioabsorbable steroid-eluting sinus implants. Laryngoscope 2011; 121:2473.
  141. Marple BF, Smith TL, Han JK, et al. Advance II: a prospective, randomized study assessing safety and efficacy of bioabsorbable steroid-releasing sinus implants. Otolaryngol Head Neck Surg 2012; 146:1004.
Topic Outline

GRAPHICS