Asthma and Chronic Rhinosinusitis: Surgical Management and Outcomes

Appropriate medical therapy is the first-line management for chronic rhinosinusitis (CRS), but patients commonly fail medical therapy and become candidates for endoscopic sinus surgery (ESS) and, potentially, extended ESS. ESS with postoperative therapies such as high-volume corticosteroid irrigation has proven to be efficacious in decreasing CRS symptoms and preventing recurrence of disease. ESS is superior to continued medical therapy in the management of refractory CRS, reduces asthma symptoms and dependence on asthma medications, and facilitates aspirin desensitization for patients with aspirin-exacerbated respiratory disease (AERD). ESS is especially beneficial when comorbid depression and the total economic burden of disease are considered.