Our evolving understanding of the pathogenesis and presentations of chronic rhinosinusitis

Our evolving understanding of the pathogenesis and presentations of chronic rhinosinusitis:



Until recently, chronic rhinosinusitis (CRS) was viewed as a chronic infectious disease of the sinuses caused by anaerobic bacteria. This dogma led to the concept that, as with any abscess in a closed space, the primary modalities of treatment should be surgical drainage and antibiotics. Not surprisingly, few patients responded favorably. Recent years have seen a revolution in our thinking, with the recognition that CRS is a chronic inflammatory disease—a syndrome comprising numerous chronic inflammatory diseases.