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ABRS. CRS. P facial P ain/pressure/fullness O nasal O bstruction D nasal purulence/discolored postnasal D ischarge S S mell disorder (hyposmia/anosmia). Major Symptoms. C facial C ongestion/fullness P facial P ain/pressure O nasal O bstruction

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Presentation Transcript
slide1

ABRS

CRS

P facial Pain/pressure/fullness

O nasal Obstruction

D nasal purulence/discolored postnasal Discharge

SSmell disorder (hyposmia/anosmia)

Major

Symptoms

C facial Congestion/fullness

P facial Pain/pressure

O nasal Obstruction

D purulent nasal Drainage

SSmell disorder (hyposmia/anosmia)

≥2 PODS, one of which must be O or D, present for >7 days without improvement.

Diagnosis

≥2 CPODS + ≥1 objective finding (endoscopy/CT), present for 8-12 weeks.

Determine CRSsNP vs CRSwNP.

Mild Moderate Severe

Mild Moderate Severe*

Severity

CRSsNP

CRSwNP

-INCS.

-If no response

within 72 hours,

consider antibiotics.

-INCS.

-Antibiotics:

1st line

Amoxicillin. TMP/SMX

or macrolide for β-

lactam allergy.

2nd line

Amoxicillin/clavulanic

acid combination or

fluoroquinolone for

risk of resistance, risk

of complications, or

1st-line failure.

Treatment

-INCS.

-Antibiotics (2nd line).

-Consider: short course

oral steroids, saline

irrigation, specialist

assessment.

-If no response in 4

weeks, refer for

surgical evaluation.

-INCS.

-Short course oral

steroids.

-Antibiotic if symptoms

of infection.

-Consider: allergy testing,

leukotriene receptor

antagonist, specialty

referral.

-If no response in 2-4

months, refer to

surgeon.

*Severe symptoms of CRS require immediate referral.