Refractory chronic rhinosinusitis: Pathophysiology and management of chronic rhinosinusitis persisting after endoscopic sinus surgery

被引:39
作者
Desrosiers, M [1 ]
机构
[1] Hop Hotel Dieu, Montreal, PQ H2W 1T8, Canada
关键词
D O I
10.1007/s11882-004-0027-z
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Refractory chronic rhinosinusitis (RCRS) is defined as persistence of signs and symptoms of chronic rhinosinusitis, despite technically adequate endoscopic sinus surgery. Rather than a simple, prolonged bout of acute sinusitis, it instead appears to be secondary to an interaction of a susceptible host with the outside environment. Inflammatory responses to colonizing bacteria appear to be responsible for a significant portion of the pathophysiology. Reduction of bacterial load and inflammation of the mucosa play an important role in controlling the disease. Novel treatment strategies, with an emphasis on topical therapies, seem to offer optimal management. In this review, current concepts on the pathophysiology and current therapies available for RCRS are outlined. A practical management strategy based on the author's personal experience draws upon these concepts, and is detailed in this review of an unusual topic.
引用
收藏
页码:200 / 207
页数:8
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