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Chronic Rhinosinusitis
Philip R. Chapman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Chronic rhinosinusitis (CRS)
              • Synonyms

                • Rhinosinusitis
              • Definitions

                • Group of disorders characterized by inflammation of nose & sinuses ≥ 12 consecutive weeks duration
                • This broad definition is based on signs and symptoms and does not restrict to specific etiology

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Hamilos DL: Pediatric chronic rhinosinusitis. Am J Rhinol Allergy. 29(6):414-20, 2015
                                              2. Huang BY et al: Current trends in sinonasal imaging. Neuroimaging Clin N Am. 25(4):507-25, 2015
                                              3. Joshi VM et al: Imaging in sinonasal inflammatory disease. Neuroimaging Clin N Am. 25(4):549-68, 2015
                                              4. Xia G et al: Differentially expressed miRNA in inflammatory mucosa of chronic rhinosinusitis. J Nanosci Nanotechnol. 15(3):2132-9, 2015
                                              5. Leo G et al: Sinus imaging for diagnosis of chronic rhinosinusitis in children. Curr Allergy Asthma Rep. 12(2):136-43, 2012
                                              6. Reddy CE et al: Imaging of granulomatous and chronic invasive fungal sinusitis: comparison with allergic fungal sinusitis. Otolaryngol Head Neck Surg. 143(2):294-300, 2010
                                              7. Cohen M et al: Biofilms in chronic rhinosinusitis: a review. Am J Rhinol Allergy. 23(3):255-60, 2009
                                              8. Nair S: Correlation between symptoms and radiological findings in patients of chronic rhinosinusitis: a modified radiological typing system. Rhinology. 47(2):181-6, 2009
                                              9. Chan Y et al: An update on the classifications, diagnosis, and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 17(3):204-8, 2009
                                              10. Smith WM et al: Regional variations in chronic rhinosinusitis, 2003-2006. Otolaryngol Head Neck Surg. 141(3):347-52, 2009
                                              11. Soler ZM et al: Relationship between clinical measures and histopathologic findings in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 141(4):454-61, 2009
                                              12. Bhattacharyya N: Relationship between mucosal inflammation, computed tomography, and symptomatology in chronic rhinosinusitis without polyposis. Ann Otol Rhinol Laryngol. 117(7):517-22, 2008
                                              13. Criddle MW et al: Pediatric chronic rhinosinusitis: a retrospective review. Am J Otolaryngol. 29(6):372-8, 2008
                                              14. Soler ZM et al: Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery. Am J Rhinol. 22(3):297-301, 2008
                                              15. Mafee MF et al: Imaging of rhinosinusitis and its complications: plain film, CT, and MRI. Clin Rev Allergy Immunol. 30(3):165-86, 2006
                                              16. Hamilos DL et al: Etiology of chronic rhinosinusitis: the role of fungus. Ann Otol Rhinol Laryngol Suppl. 193:27-31, 2004
                                              17. Senior K: Is chronic rhinosinusitus a fungal problem? Lancet Infect Dis. 4(5):257, 2004
                                              18. Benninger MS et al: Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 129(3 Suppl):S1-32, 2003
                                              19. Bhattacharyya N et al: The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope. 113(1):125-9, 2003
                                              20. Hwang PH et al: Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg. 128(4):489-96, 2003
                                              21. Stankiewicz JA: Endoscopic and imaging techniques in the diagnosis of chronic rhinosinusitis. Curr Allergy Asthma Rep. 3(6):519-22, 2003
                                              22. Khalid AN et al: The role of bone in chronic rhinosinusitis. Laryngoscope. 112(11):1951-7, 2002
                                              23. Emanuel IA et al: Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 123(6):687-91, 2000
                                              24. Krouse JH: Computed tomography stage, allergy testing, and quality of life in patients with sinusitis. Otolaryngol Head Neck Surg. 123(4):389-92, 2000
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Chronic rhinosinusitis (CRS)
                                                          • Synonyms

                                                            • Rhinosinusitis
                                                          • Definitions

                                                            • Group of disorders characterized by inflammation of nose & sinuses ≥ 12 consecutive weeks duration
                                                            • This broad definition is based on signs and symptoms and does not restrict to specific etiology

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Hamilos DL: Pediatric chronic rhinosinusitis. Am J Rhinol Allergy. 29(6):414-20, 2015
                                                                                          2. Huang BY et al: Current trends in sinonasal imaging. Neuroimaging Clin N Am. 25(4):507-25, 2015
                                                                                          3. Joshi VM et al: Imaging in sinonasal inflammatory disease. Neuroimaging Clin N Am. 25(4):549-68, 2015
                                                                                          4. Xia G et al: Differentially expressed miRNA in inflammatory mucosa of chronic rhinosinusitis. J Nanosci Nanotechnol. 15(3):2132-9, 2015
                                                                                          5. Leo G et al: Sinus imaging for diagnosis of chronic rhinosinusitis in children. Curr Allergy Asthma Rep. 12(2):136-43, 2012
                                                                                          6. Reddy CE et al: Imaging of granulomatous and chronic invasive fungal sinusitis: comparison with allergic fungal sinusitis. Otolaryngol Head Neck Surg. 143(2):294-300, 2010
                                                                                          7. Cohen M et al: Biofilms in chronic rhinosinusitis: a review. Am J Rhinol Allergy. 23(3):255-60, 2009
                                                                                          8. Nair S: Correlation between symptoms and radiological findings in patients of chronic rhinosinusitis: a modified radiological typing system. Rhinology. 47(2):181-6, 2009
                                                                                          9. Chan Y et al: An update on the classifications, diagnosis, and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 17(3):204-8, 2009
                                                                                          10. Smith WM et al: Regional variations in chronic rhinosinusitis, 2003-2006. Otolaryngol Head Neck Surg. 141(3):347-52, 2009
                                                                                          11. Soler ZM et al: Relationship between clinical measures and histopathologic findings in chronic rhinosinusitis. Otolaryngol Head Neck Surg. 141(4):454-61, 2009
                                                                                          12. Bhattacharyya N: Relationship between mucosal inflammation, computed tomography, and symptomatology in chronic rhinosinusitis without polyposis. Ann Otol Rhinol Laryngol. 117(7):517-22, 2008
                                                                                          13. Criddle MW et al: Pediatric chronic rhinosinusitis: a retrospective review. Am J Otolaryngol. 29(6):372-8, 2008
                                                                                          14. Soler ZM et al: Symptom-based presentation of chronic rhinosinusitis and symptom-specific outcomes after endoscopic sinus surgery. Am J Rhinol. 22(3):297-301, 2008
                                                                                          15. Mafee MF et al: Imaging of rhinosinusitis and its complications: plain film, CT, and MRI. Clin Rev Allergy Immunol. 30(3):165-86, 2006
                                                                                          16. Hamilos DL et al: Etiology of chronic rhinosinusitis: the role of fungus. Ann Otol Rhinol Laryngol Suppl. 193:27-31, 2004
                                                                                          17. Senior K: Is chronic rhinosinusitus a fungal problem? Lancet Infect Dis. 4(5):257, 2004
                                                                                          18. Benninger MS et al: Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 129(3 Suppl):S1-32, 2003
                                                                                          19. Bhattacharyya N et al: The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope. 113(1):125-9, 2003
                                                                                          20. Hwang PH et al: Radiologic correlates of symptom-based diagnostic criteria for chronic rhinosinusitis. Otolaryngol Head Neck Surg. 128(4):489-96, 2003
                                                                                          21. Stankiewicz JA: Endoscopic and imaging techniques in the diagnosis of chronic rhinosinusitis. Curr Allergy Asthma Rep. 3(6):519-22, 2003
                                                                                          22. Khalid AN et al: The role of bone in chronic rhinosinusitis. Laryngoscope. 112(11):1951-7, 2002
                                                                                          23. Emanuel IA et al: Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 123(6):687-91, 2000
                                                                                          24. Krouse JH: Computed tomography stage, allergy testing, and quality of life in patients with sinusitis. Otolaryngol Head Neck Surg. 123(4):389-92, 2000