TY - JOUR T1 - The management of chronic rhinosinusitis in primary care: an evidence-based guide JF - British Journal of General Practice JO - Br J Gen Pract SP - 44 LP - 45 DO - 10.3399/bjgp19X700637 VL - 69 IS - 678 AU - Peter G Deutsch AU - Sophie Lord AU - Sebastian Salamat AU - Karan Jolly Y1 - 2019/01/01 UR - http://bjgp.org/content/69/678/44.abstract N2 - Presentations to general practice with the myriad of symptoms associated with chronic rhinosinusitis (CRS) are extremely common. The mainstay of management of this condition is carried out in primary care.1 This article covers the diagnosis and management of adult CRS in the light of evidence from the European position paper from 2012 on this condition.2CRS is reported to affect 5–15% of the general population but only 2–4% of this is diagnosed by a doctor.3 Awareness of the relevant definitions will aid diagnosis and management of this common, but underdiagnosed, condition.Adult rhinosinusitis is defined as: ‘Inflammation of the nose and paranasal sinuses characterised by two or more of the following symptoms.’ 2At least one of these must be: nasal blockage; ornasal discharge (including postnasal drip).Other ‘non-essential’ symptoms that contribute to diagnosis include: facial pain/pressure; orreduction or loss of sense of smell.Continuation of symptoms for >12 weeks differentiates chronic from acute rhinosinusitis.1This definition can be refined with the aid of flexible nasendoscopy. This can help subdivide patients with CRS into two groups: those with and without nasal polyps.2Patients with CRS may present to general practice with a wide array of symptoms.1 Along with those identified above there are a range of symptoms including:3,4 persistent cough/throat clearing;headache;dysphonia (change in quality of voice); anddrowsiness/malaise.The use of symptom severity scales, such as the visual analogue scale … ER -