Chronic rhinosinusitis without nasal polyps

Patients are followed long-term according to their level of symptoms. One of the main goals is to decrease chronic inflammation and the number of acute exacerbations requiring antibiotics. Patients are encouraged to continue treatment of any underlying conditions (e.g., asthma, allergic rhinitis). Follow-up with nasal endoscopy is required for evaluation. Post-operative management will include serial endoscopy with patients returning to the clinic when symptoms recur or at 6- to 12-month intervals, depending on response to therapy. Sinus cultures are performed if recurrence of infection or debridement of the nasal cavity is performed on follow-up with the otolaryngologist. Endoscopic sinus cleaning or debridement a few days after surgery is often performed during the first and possibly second post-operative visits. Crusts and clots from surgery are removed. Endoscopic cultures are performed to evaluate acute exacerbations, which may benefit from culture-directed antibiotics.