CHRONIC RHNOSINUSITIS: CLINICAL MANIFESTATIONS AND OUTPATIENT TREATMENT

Abstract

Introduction: Chronic rhinosinusitis is a prevalent and complex condition, characterized by persistent inflammation of the nasal mucosa and paranasal sinuses for a period of more than 12 weeks, even with adequate treatment. The etiology of this disease is multifactorial, including bacterial infections, allergic factors, anatomical anomalies and immunological disorders. Symptoms, such as nasal congestion, facial pain and reduced sense of smell, significantly impact patients' quality of life, interfering with daily activities and general well-being. Given the complexity of management and prolonged health impact, chronic rhinosinusitis remains a significant challenge for medicine. Objective: This systematic literature review aimed to identify and analyze the most effective therapeutic approaches for the outpatient treatment of chronic rhinosinusitis, focusing on interventions that improve quality of life and prevent complications. Methodology: The methodology followed the PRISMA checklist, using the PubMed, Scielo and Web of Science databases, with the search limited to articles published in the last 10 years. The descriptors used included "chronic rhinosinusitis", "treatment", "quality of life", "sinus surgery" and "inflammation". The inclusion criteria covered randomized clinical studies, systematic reviews and meta-analyses that addressed the treatment of chronic rhinosinusitis in adults. Studies focusing on pediatric populations, opinion articles and those published in languages ​​other than English, Portuguese and Spanish were excluded. Results: The results indicated that the combination of nasal corticosteroids and antibiotics represents the mainstay of treatment, with endoscopic surgery being effective in refractory cases. The review also highlighted the importance of patient education in adherence to treatment and prevention of complications. Patients' quality of life was significantly improved with personalized interventions, which included management of environmental factors and control of associated comorbidities. Conclusion: In summary, chronic rhinosinusitis, being a complex management condition, requires a multifaceted therapeutic approach. The review pointed out that, although surgical interventions are effective in refractory cases, drug therapy, combined with patient education, is crucial for controlling the disease and improving quality of life. Continuous advancement in research and clinical practice is essential to improve management strategies for this debilitating condition.