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J Allergy Clin Immunol. 2018 May;141(5):1561-1569. doi: 10.1016/j.jaci.2018.03.003. Epub 2018 Mar 29.

Evolution in the surgical management of chronic rhinosinusitis: Current indications and pitfalls.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa.
2
Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa.
3
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa. Electronic address: David.Kennedy@uphs.upenn.edu.

Abstract

Chronic rhinosinusitis (CRS) consists of a range of inflammatory conditions in the sinuses that can result in clinical symptoms. The underlying pathophysiology and its relationship to lower airway disease are complex. Current definitions of CRS can serve more as an indication for potential surgical intervention rather than a marker of disease state. CRS can be asymptomatic and may require medical management to avoid disease progression and minimize the risk of lower airway disease. Endoscopic surgery has undergone a significant evolution and refinement, but the most common surgical complication remains persistent inflammation and disease recurrence. It is important to recognize that surgery alone rarely cures CRS and patients require long-term medical therapy for continued asymptomatic inflammation. Careful postoperative care and endoscopic follow-up to ensure resolution of inflammation are key to ensuring optimal surgical outcomes and reduce the risk of revision surgery. Future work on CRS endotypes will allow discovery of new therapies to treat CRS, as well as refine indications for medical or surgical intervention and postoperative care.

KEYWORDS:

Chronic rhinosinusitis; endoscopic surgery; nasal polyps; surgical complications

PMID:
29605619
DOI:
10.1016/j.jaci.2018.03.003
[Indexed for MEDLINE]

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