Current Allergy and Asthma Reports

, Volume 13, Issue 2, pp 236-243

First online:

Oral Steroid Therapy in Chronic Rhinosinusitis with and without Nasal Polyposis

  • Brittany E. HowardAffiliated withDepartment of Otolaryngology, Mayo Clinic Arizona
  • , Devyani LalAffiliated withDepartment of Otolaryngology, Mayo Clinic ArizonaDepartment of Otolaryngology – Head and Neck Surgery, Mayo Clinic Arizona Email author 

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Chronic rhinosinusitis (CRS) is a heterogeneous group of disorders characterized by inflammation of the sinonasal mucosa. CRS can be divided into two subtypes: CRS without polyps (CRSsNP) and CRS with nasal polyps (CRSwNP). Corticosteroids are frequently employed to treat CRS due to their potent anti-inflammatory effects. Treatment of CRS with oral steroids must be carefully balanced against potential adverse effects. This article reviews the current literature on management of CRS with systemic corticosteroids. We discuss the available evidence in CRSsNP, CRSwNP, and allergic fungal sinusitis (AFS). Studies are evaluated for level of evidence and graded to provide evidence-based recommendations. Our review finds a lack of high-quality evidence supporting oral corticosteroid therapy in CRSsNP. In comparison, randomized controlled trails support the use of oral corticosteroids for CRSwNP. Similarly, systemic steroids for AFS treatment are supported by quality studies demonstrating efficacy. Utilization of steroids is also recommended in the perioperative setting for CRSwNP.


Corticosteroids Steroids Chronic rhinosinusitis Sinusitis Nasal polyps Allergic fungal sinusitis Evidence-based medicine Review Recommendations Management Perioperative Preoperative Postoperative Oral steroid therapy