The goals of treatment in patients with chronic rhinosinusitis are to manage symptoms and improve or maintain quality of life. treatment is directed at enhancing mucociliary clearance, improving sinus drainage/outflow, eradicating local infection and inflammation, and improving access for topical medications. 18 treatment consists of medical management, and endoscopic sinus surgery if appropriate medical management is unsuccessful. 18 many patients with chronic rhinosinusitis have allergies, asthma, and other less common comorbidities (e. g. vasculitides, granulomatous diseases, cystic fibrosis, immunodeficiency) that directly contribute to chronic rhinosinusitis. 18 odontogenic infections may also contribute to chronic rhinosinusitis. therefore, patients not responding to first-line medical therapy should be referred to an otolaryngologist, and patients with a history of (or suggestive of) these comorbidities may also benefit from referral to an allergist or pulmonologist. intranasa...