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Chronic Rhinosinusitis

According to the EP3OS document, CRS should be treated in the stepwise fashion, considering severity of subjective symptoms and the impact on quality of life. In the mild disease, patients with CRS are primarily treated with saline or hypertonic saline nasal douching, followed by the application of local corticosteroids. In more severe cases, when no response to nasal douching and nasal steroid sprays is achieved, patient may try the treatment with long term low dose antibiotics, before referred to surgery. Acute exacerbations of rhinosinusitis in patients with CRS, are usually de novo infection by bacteria, and should be treated with targeted antibiotic. The treatment of CRS is a long-run treatment which most often ends up with surgical procedure. However, even after the surgery, similar kind of medical treatment, i.e. douching and intermittent topical steroids, should be continued and follow up by the surgeon is necessary.