Approach to the evaluation and medical management of chronic rhinosinusitis.

Despite the many frustrations involved in the care of CRS, there are many "successes," and most patients experience at least moderate benefit from medical treatment. I cannot emphasize enough the importance of breaking down the evaluation into component parts and addressing each one. Often, successful treatment is only achieved after all elements of the treatment program are in place. Patients are typically desperate for improvement and understand that several different strategies may need to be tried before a successful program is found. Given the high impact of CRS on patients' quality of life, it is not surprising that some of the most grateful patients are the ones in whom a successful medical program has been discovered.