Chronic Rhinosinusitis (CRS)
Chronic sinusitis is also called chronic rhino-sinusitis because it affects the the upper respiratory passages like the nose as well as the sinuses. Many patients with Chronic rhinosinusitis (CRS) have nasal polyps as well. Nasal polyps are “grape-like” masses that grow from the lining of the nasal passages and sinuses. Currently, the main therapies for CRS are saline solution irrigation, intranasal or systemic (injected or taken by mouth) steroids and intranasal and systemic antibiotics. For patients with allergies, allergen immunotherapy -AKA “allergy shots” -may offer some relief as well.
In a recent review article, “Chronic rhinosinusitis management beyond intranasal steroids and saline irrigations” by Dr.’s Newton, Li and Peters in the Allergy Asthma Proceedings, September-October 2015 found for patients with CRS and nasal polyps that both intranasal and systemic steroids provided positive benefits. For acute flare-ups, antibiotics are helpful as well. However, for patients with CRS and no polyps the response to treatments were variable.
As an aside, the authors pointed to optimism for both groups because of new injectable therapies that target biochemical pathways that lead to polyp production. Proteins called cytokines are part of this pathway. The medicines that block them are called monoclonal antibodies. At Asthma & Allergy Associates we are familiar with all of these therapies. As well, our research center is participating in many clinical trials for the investigational monoclonal antibody therapies.