Evolution in the Surgical Management of Chronic Rhinosinusitis: Current Indications and Pitfalls

Publication date: Available online 29 March 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Michael A. Kohanski, Elina Toskala, David W. Kennedy
Chronic rhinosinusitis (CRS) consists of a range of inflammatory conditions in the sinuses that may result in clinical symptoms and the underlying pathophysiology and its relationship to lower airway disease is complex. Current definitions of CRS may 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 to 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 recurrence of disease. It is important to recognize that surgery alone rarely cures CRS and patients require long-term medical therapy for continued asymptomatic inflammation. Careful post-operative care and endoscopic follow-up to ensure resolution of inflammation is key to ensuring optimal surgical outcomes and reduce the risk of revision surgery. Future work on CRS endotypes will allow for discovery of new therapies to treat CRS as well as refine indications for medical or surgical intervention as well as post-operative care.



https://ift.tt/2E6dL8x