Next Article in Journal
Sinusitis and Respiratory Disease at Pediatric Age
Previous Article in Journal / Special Issue
LTD4 and TGF-β1 Induce the Expression of Metalloproteinase-1 in Chronic Rhinosinusitis via a Cysteinyl Leukotriene Receptor 1-Related Mechanism
Article Menu

Export Article

From the third issue of 2018, Sinusitis has changed its name to Sinusitis and Asthma.

Open AccessFeature PaperReview
Sinusitis 2016, 1(1), 76-87;

Medical Management of Chronic Rhinosinusitis in Adults

Department of Community Health and Family Medicine, University of Florida, Gainesville, FL 32609, USA
Academic Editor: Claudina A. Pérez Novo
Received: 15 March 2016 / Revised: 8 May 2016 / Accepted: 24 May 2016 / Published: 28 May 2016
(This article belongs to the Special Issue Chronic Rhinosinusitis: Clinical and Immunological Research)
Full-Text   |   PDF [227 KB, uploaded 28 May 2016]


Chronic rhinosinusitis can be refractory and has detrimental effects not only on symptoms, but also on work absences, work productivity, annual productivity costs, and disease-specific quality of life measures. The pathophysiology of chronic rhinosinusitis continues to evolve. There is evidence that it is driven by various inflammatory pathways and host factors and is not merely an infectious problem, although pathogens, including bacterial biofilms, may certainly contribute to this inflammatory cascade and to treatment resistance. Given this, medical management should be tailored to the specific comorbidities and problems in an individual patient. In addition to treating acute exacerbations of chronic rhinosinusitis with amoxicillin-clavulanate, second or third generation cephalosporins, or fluoroquinolones, one must consider if nasal polyps are present, when symptoms and disease severity correlate to mucosal eosinophilia, and there is the best evidence for intranasal corticosteroids and saline irrigation. Asthma worsens severity of chronic rhinosinusitis and it is felt to be mediated by increased leukotrienes, when leukotriene antagonists may be utilized. Cystic fibrosis has a genetic defect and increased mucin, which are potential treatment targets with dornase alfa showing efficacy. Other comorbidities that may impact treatment include allergies, ciliary dyskinesia, immunodeficiency, and possibly allergic fungal rhinosinusitis. View Full-Text
Keywords: treatment; medical; management; chronic; sinusitis; rhinosinusitis; adult; polyps treatment; medical; management; chronic; sinusitis; rhinosinusitis; adult; polyps
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Malaty, J. Medical Management of Chronic Rhinosinusitis in Adults. Sinusitis 2016, 1, 76-87.

Show more citation formats Show less citations formats

Article Metrics

Article Access Statistics



[Return to top]
Sinusitis EISSN 2309-107X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top