Dykewicz and Hamilos reported criteria for making the diagnosis of chronic rhinosinusitis. The authors are from Wake Forest University and Massachusetts General Hospital.


Chronic rhinosinusitis is divided into two groups based on the presence or absence of nasal polyps.


Features of chronic rhinosinusitis - all of the following:

(1) Symptoms are present for more than 12 weeks.

(2) 3 or 4 of the following clinical findings:

(2a) mucopurulent drainage, anterior and/or posterior

(2b) nasal congestion

(2c) facial pressure and/or facial pain

(2d) decreased sense of smell

(3) evidence of inflammation on one or both of the following

(3a) rhinoscopic examination

(3b) CT sinus scan or other imaging study


The diagnosis of nasal polyps is made by the presence of bilateral nasal polyps in the middle meatus.


Differential diagnosis:

(1) The presence of a single, unilateral polyp may indicate the presence of a nasal tumor.

(2) Allergic fungal rhinosinusitis (AFRS, see next) needs to be excluded.


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