Chronic Rhinosinusitis

How do the organisms in chronic rhinosinusitis differ from those in the acute setting? Discuss how the choice in antibiotic therapies differ in chronic sinusitis compared to acute sinusitis.

Discuss the pathogenesis of chronic sinusitis. What is the staphylococcal superantigen hypothesis?

What is the significance of eosinophilia in chronic rhinosinusitis.

Reference(s):

Zadeh, M. H., Banthia, V., Anand, V. K., & Huang, C. (2002). Significance of eosinophilia in chronic rhinosinusitis. American Journal of Rhinology, 16(6), 313–317.

What is Churg-Strauss syndrome?

Discuss the pathogenesis of Samter’s triad.

Discuss the role of the SNOT-22 in the diagnosis and treatment of CRS.

Reference(s):

Rudmik, L., Soler, Z. M., Mace, J. C., DeConde, A. S., Schlosser, R. J., & Smith, T. L. (2015). Using preoperative SNOT-22 score to inform patient decision for Endoscopic sinus  surgery. The Laryngoscope, 125(7), 1517–1522.

Is sinus pressure indicative of sinus disease?

Reference(s):

Lal, D., Rounds, A., & Dodick, D. W. (2015). Comprehensive management of patients presenting to the otolaryngologist for sinus pressure, pain, or headache. The Laryngoscope, 125(2), 303–310.

Discuss the medical therapy of chronic rhinosinusitis. Does your rhinologist have an algorithm?

Discuss the side effects of nasal steroid sprays. How can you minimize the side-effects? Are they safe in pregnancy?

What is the role of anti-inflammatory therapies such as leukotriene receptor antagonist and anti-IgE monoclonal antibodies in CRS?

Is it safe to use Afrin daily?

Reference(s):

Meltzer, E. O., Bernstein, D. I., Prenner, B. M., Berger, W. E., Shekar, T., & Teper, A. A. (2013). Mometasone furoate nasal spray plus oxymetazoline nasal spray: short-term efficacy and safety in seasonal allergic rhinitis. American Journal of Rhinology & Allergy, 27(2), 102–108.

Discuss the differences between treatments for CRS with nasal polyp and without nasal polyps.

When is surgical intervention indicated for the treatment of chronic rhinosinusitis?

Describe the role of topical antibiotic therapy in patients with CRS that have failed surgical therapy.

Reference(s):

Lee, J. T., & Chiu, A. G. (2014). Topical anti-infective sinonasal irrigations: update and literature review. American Journal of Rhinology & Allergy, 28(1), 29–38.

Discuss biofilms and chronic rhinosinusitis.

Reference(s):

Ramakrishnan, Y., Shields, R. C., Elbadawey, M. R., & Wilson, J. A. (2015). Biofilms in chronic rhinosinusitis: what is new and where next? The Journal of Laryngology and Otology, 129(8), 744–751.

Discuss the relationship between asthma and sinus disease.

Reference(s):

Stachler, R. J. (2015). Comorbidities of asthma and the unified airway. International Forum of Allergy & Rhinology, 5 Suppl 1, S17-22.

Does reflux play a role in chronic sinusitis?

Reference(s):

Loehrl, T. A., Samuels, T. L., Poetker, D. M., Toohill, R. J., Blumin, J. H., & Johnston, N. (2012). The role of extraesophageal reflux in medically and surgically refractory rhinosinusitis. The Laryngoscope, 122(7), 1425–1430.