Chronic rhinosinusitis: observation or treatment.

PURPOSE OF REVIEW: Several treatment options have been proposed for chronic rhinosinusitis (CRS). Our purpose is to present a protocol/tool to treat patient symptoms, which is initially independent of assessment for presence of CRS.

RECENT FINDINGS: This protocol is called the Rational Patient Experiment (RPE), and its concept is largely based on the fact that CRS is overrepresented in incidence based on surveys, because symptoms of CRS are nonspecific and overlap multiple other disorders. Patients whose symptoms persist, despite the RPE, require further objective assessment of CRS with endoscopy and computed tomography.

SUMMARY: This review outlines the RPE and the evidence base for observation versus treatment with saline washes, steroids, or antibiotics.