A Proposal for a Staging System for Hyperplastic Rhinosinusitis Based on the Presence or Absence of Intranasal Polyposis

This study of 30 patients with hyperplastic rhinosinusitis reveals that the major determinant of the success or failure of conservative therapy is the presence or absence of intranasal polyposis. When polyposis is confirmed both clinically and radiographically, surgical intervention appears to be the rational way to handle most cases. When intranasal polyps are not present, an aggressive medical regimen is called for, one that includes a short-term, low-dose oral corticosteroid and an antibiotic, along with periodic radiographic assessment. Regardless of how much disease is seen on computed tomography, if it does not also detect intranasal polyps or masses, the potential for clearing with conservative therapy is extremely high.