Sinusitis is defined as inflammation of the paranasal sinuses due to infection, allergy, autoimmune issues or physical obstructions. Sinusitis affects an estimated 14% of the population in the US (approximately 37 million people), is a leading cause of patient referrals to otolaryngologists, and represents an estimated $8.6 billion in annual treatment costs. Approximately 1 in 7 sinusitis patients will progress to the chronic form of the disease, termed chronic rhinosinusitis or CRS, representing about 13 million patients. This CRS group is responsible for 11.7 million patient visits annually and an estimated $2.4 billion of annual direct health care expenditures.
Sinusitis is classified into “acute” (lasting less than 4 weeks) and “chronic” (lasting > 12 weeks) conditions. Acute conditions are often of viral etiology and the patient receives only supportive therapy such as saline irrigation. Treatment of the chronic rhinosinusitis patient consists of multiple courses of antibiotics, local and systemic corticosteroid therapy, antifungal drugs and aspirin desensitization therapy. The chronic, indolent state of the disease often results in anosmia, insomnia, and a variety of co-morbid conditions such as headache and halitosis, all potentially contibuting to patient depression. It is estimated that the rate of CRS in the Western world is 15% of the population.