ABSTRACT
CRS is a highly prevalent disease, affecting over 12.5 percent of the US population, and accounting for a signifi cant patient and health-care economic burden.1 Quality of Life (QOL) impairments in CRS patients are comparable in severity to disease states such as congestive heart failure, chronic obstructive pulmonary disease and chronic lower back pain.2,3 The diagnosis of CRS is made by history, physical examination, nasal endoscopy or CT scan as shown in Table 8.1.4
Nasal polyps
Nasal polyps are found in a subset of patients with CRS (CRSwNP) (Fig. 8.1). Contrary to historical dogma, atopic patients are not at increased risk for development of nasal polyps. However, CRS patients with asthma are more likely to have nasal polyps than those without asthma. Multiple infl ammatory mechanisms are implicated in the development of nasal polyps. In some patients, Th2-mediated infl ammation and eosinophilic disease is present, in others Th1-mediated pathways and neutrophilic disease predominates. These subgroups of CRSwNP patients may respond to different medications.
