LAUSR

Often in medicine, what seems simple is actually very complex. That is the case with chronic rhinosinusitis (CRS). CRS is a common chronic illness in the United States and worldwide, affecting all age groups. In the United States, its prevalence is 146 per 1000 population; 12.3% of adults are diagnosed with CRS, according to Centers for Disease Control and Prevention data. In Europe, the incidence is 10.9%, as per GA2LEN data. In China, it may be as high as 13%. Self-diagnosis and treatment complicate our ability to understand the actual prevalence of this disorder. There is a plethora of over-the-counter and herbal remedies for CRS, and this condition is managed by the following: the patient themselves in self-diagnosis, family physicians, internists, pediatricians, allergists, nurse practitioners, and otolaryngologists. But such a common and vexing condition is not simple, with layers of potential causes, findings, treatments, and reasons for treatment failures. In addition, the association of CRS with lower airways disease, including asthma, makes this more than just a stuffy nose problem. Genetic susceptibility, various viral and bacterial pathogens, existence of biofilms that make treatment very difficult, and mucosal and bony changes, including polyposis and osteitis, all lead to the complexity of this condition. Drs Abtin Tabaee and Edward D. McCoul have compiled a comprehensive review of CRS in this issue of Otolaryngologic Clinics of North America. The reader will be left with a thorough understanding of the state-of-the-art and -science in diagnosing, determining cause, and offering targeted medical, office-based, and/or surgical therapies to the patient who presents with CRS. I congratulate the authors of each article