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Chronic

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Chronic rhinosinusitis (CRS) is the persistence of symptoms for more than 12 weeks (1)

The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) defines chronic rhinosinusitis (CRS) (including nasal polyps) as:

Inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip):

  • ± facial pain/pressure
  • ± reduction or loss of smell. for >12 weeks

CRS can be differentiated according to the presence of nasal polyps into: CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP).

CRS constitutes one of the commonest conditions encountered in medicine and may present to a wide range of clinicians from primary care to accident and emergency, pulmonologists, allergists, otorhinolaryngologists and even intensivists and neurosurgeons when severe complications occur

  • 2012 EPOS reported that it may affect between 5% and 15% of the population in Europe and the United States (2),

Notes:

  • most cases of chronic sinusitis do not follow acute sinusitis. Frank bacterial infection is often absent, and if there is bacterial infection present it may be secondary infection
  • recurrent sinusitis is defined as more than three significant acute episodes annually, each lasting for 10 days or more (1)

Reference:

  1. Ah-See KL et al. Management of chronic rhinosinusitis. BMJ. 2012;345:e7054.
  2. Fokkens WJ et al.European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl. 2012;23:3 p

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