Complicated rhinosinusitis

Complicated rhinosinusitis: a title chosen for its multi-interpretable nature. In the Oxford dictionary ‘complicated’ is defined as ‘consisting of many interconnecting parts or elements’ and ‘involving many different and confusing aspects’ as well as ‘involving complications’ in medicine.
It is the last definition that is applicable to chapter 2 which focuses on the medical complications of acute rhinosinusitis. Chapter 2.1 describes the incidence and management of orbital and intracranial complications of acute rhinosinusitis in The Netherlands. Chapter 2.2 concentrates on Pott’s puffy tumour, a rare complication of acute frontal sinusitis. We present a series of six cases in which this complication is treated by minimally invasive surgery.
As stated earlier, rhinosinusitis is considered a multifactorial disease with different potential pathophysiological mechanisms, which are not fully understood. Indeed a complicated disease with many interconnecting parts and confusing aspects, making its treatment a challenge to the physician. This challenge is the subject of chapter 3. In chapter 3.1 we report the results of a randomized clinical trial investigating the efficacy of corticosteroid nasal spray delivered by a new device, while chapters 3.2 and 3.3 address radical sinus surgery for recalcitrant chronic rhinosinusitis as a last resort option. In chapter 3.2 we report the results of Draf type III frontal sinus surgery in 122 patients and in chapter 3.3 the results of frontal sinus obliteration in 40 patients.