ABSTRACT
Clinicians experienced in treating chronic rhinosinusitis (CRS) recognize it as a syndrome rather than a single disease process. They also recognize that not everyone with complaints of “sinusitis” or a “sinus problem” actually has rhinosinusitis. There is considerable overlap of the symptoms of rhinosinusitis with other conditions, including allergic and nonallergic types of rhinitis, especially conditions associated with facial pain or headaches. Nonetheless, certain “patterns” of illness can be described within the syndrome of rhinosinusitis, and these provide some insight into the underlying causes of illness. This chapter describes these patterns based on clinical case series, including the results of an Outcomes Study performed at Washington University School of Medicine (WUSM) and the author’s more recent experience at Massachusetts General Hospital (MGH). Understanding the pattern of illness can lead to more accurate diagnosis of causative and contributive factors in the disease and should ultimately translate to more effective therapies.
