This book will aim to educate practicing otolaryngologists and trainees in the diverse spectrum of surgical and medical interventions available for recalcitrant CRS, with an emphasis on novel therapeutic modalities. Chronic rhinosinusitis (CRS) represents one of the most common healthcare problems in the United States (US), with 1 in 6 adults affected and 31 million individuals newly diagnosed each year. Over 22 billion dollars are spent annually in US health care expenditures due to the cost of prescription medications, surgical interventions, and loss of productivity. Management of CRS recalcitrant to standard medical and surgical intervention continues to present a challenge for many otolaryngologists. An overall productivity cost of $10000/per patient per year is estimated for those with such refractory CRS. The last decade has seen significant expansion in our treatment armamentarium for such recalcitrant disease. New surgical approaches, minimally invasive techniques, endoscopic instrumentation, technologic innovations, in-office procedures, etc. have been developed. Systemic immunomodulatory biologics and a vast array of topical agents have also been introduced. These novel therapeutic options have been the topic of numerous panel presentations at educational conferences/courses by the co-editors but no textbook to date has been published focusing on this important subject. Chapters addressing operative and clinic procedures will offer accompanying videos depicting surgical techniques in addition to illustrations and step-by-step descriptions. Sections reviewing new technology and medical therapies will also include tables and reviews of the pertinent literature. Advances in Surgical and Medical Interventions for Recalcitrant Chronic Rhinosinusitis will serve otolaryngologists and trainees in the most up-to-date techniques both surgical and otherwise to address this pervasive issue. It describes new surgical approaches and recent technologic innovations for management of recalcitrant chronic rhinosinusitis, discuss novel medical therapies including nascent systemic biotherapeutics, immunomodulators, and topical additives to assess their potential role in the treatment of refractory chronic rhinosinusitis, and assist practitioners in understanding the relevant evidence, outcomes, and proper application of each therapeutic modality in patients with recalcitrant chronic rhinosinusitis.
