Management of Chronic Rhinosinusitis with or Without Nasal Polyposis.

Chronic rhinosinusitis (CRS) is a complex disease with multiple phenotypes. The primary phenotypic division is CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). The majority of patients with CRSwNP have type 2 inflammatory disease characterized by eosinophilic inflammation and type 2 cytokines (primarily interleukin-4, 5, and 13). CRS is not primarily an infectious problem, although viral and bacterial infections or dysbiosis may exacerbate the disease. There is an association of CRS with asthma, particularly CRSwNP. Treatment of the CRS benefits asthma.