Phenotypes of Chronic Rhinosinusitis

In this paper, Drs. Cho, Hamilos, Han, and Laidlaw review the diagnoses and treatments for different types of chronic rhinosinusitis (CRS) . The two most commonly described phenotypes of CRS are CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). There is actually a third main phenotype called allergic fungal rhinosinusitis which is characterized by inflammation in response to fungus in nasal mucus. Aside from the three main phenotypes, there are also sub-phenotypes such as cystic fibrosis and aspirin-exacerbated respiratory disease (AERD). Each type of CRS requires different treatments.  The nasal polyps in patients with AERD are eosinophilic and are often recurrent and difficult to manage. Treatments for CRS range from intranasal corticosteroids, saline irrigations, antibiotics, endoscopic sinus surgery and more recently, biologics. The specifics on each phenotype and their corresponding treatment methods can be found here.