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Medical Management of Chronic Rhinosinusitis in Children and Adults

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Diseases of the Sinuses

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Abstract

Chronic rhinosinusitis (CRS) is an inflammatory condition affecting the nasal passageways and sinuses lasting over 12 weeks. CRS is treated with multiple medical therapies in children and adults. Topical nasal corticosteroids are recommended for CRS with and without nasal polyps by multiple rhinosinusitis guidelines and evidence-based meta-analyses. The safety profile of nasal corticosteroids is excellent. The majority of studies show no adrenal suppression. Further, no growth suppression is seen in children using low dosages and side effects are generally mild. Nasal saline irrigation has also led to an improvement in symptom scores and quality of life measures using isotonic and hypertonic saline solutions. A Cochrane review states that medical management of CRS is as effective as surgical therapy based on available data. This highlights the important role of specialists in allergy/immunology and otolaryngology that have expertise in the treatment of CRS. Additional high-level evidence is urgently needed to best define optimal treatment strategies and which subgroups of CRS may respond best to the various medical treatments.

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Authors and Affiliations

  1. Department of Allergy/Immunology and Sleep Medicine, University Hospitals of Cleveland, 34055 Solon Road #104A, Solon, OH, 44139, USA

    Samuel L. Friedlander MD

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  1. Samuel L. Friedlander MD
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Editors and Affiliations

  1. Division of Allergy and Immunology, Department of Pediatrics, Thomas Jefferson University, Wilmington, Delaware, USA

    Christopher C. Chang

  2. Division of Rheumatology, Allergy and Clinical Immunology, University of California School of Medicine, Davis, California, USA

    Gary A. Incaudo

  3. The Jack and Donald Chia Distinguished Professor of Medicine, Division of Rheumatology, Allergy and Clinical Immunology, University of California School of Medicine, Davis, California, USA

    M. Eric Gershwin

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Friedlander, S.L. (2014). Medical Management of Chronic Rhinosinusitis in Children and Adults. In: Chang, C., Incaudo, G., Gershwin, M. (eds) Diseases of the Sinuses. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0265-1_20

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  • DOI: https://doi.org/10.1007/978-1-4939-0265-1_20

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-0264-4

  • Online ISBN: 978-1-4939-0265-1

  • eBook Packages: MedicineMedicine (R0)

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