Prospective observational study of chronic rhinosinusitis: Environmental triggers and antibiotic implications

Abstract

Background. A prolonged course of antibiotic therapy is often initiated for chronic rhinosinusitis (CRS) based on symptomatology. We examined differences in clinical manifestations and underlying conditions in patients with symptoms typical for CRS. CT scan abnormality of the sinuses was the gold standard for diagnosis of CRS. Methods. We performed a prospective observational study of 125 adults with classic symptoms of CRS undergoing nasal endoscopy and sinus CT. Results. The patients were classified into 2 groups: (1) those with radiographic evidence of sinusitis by CT (Sx + CT) (75) and (2) those with normal CT scans of the sinus (Sx-CT) (50). Decreased smell was significantly more common in Sx + CT than in Sx-CT patients, (P =. 003). Paradoxically, headache, facial pain, and sleep disturbance occurred significantly more frequently in patients with Sx-CT than in patients with Sx + CT (P