Oral Steroids in Chronic Rhinosinusitis Without Nasal Polyps

The investigators will compare patients with CRSsNP who are treated with antibiotics/nasal
steroid sprays, and compare them to chronic sinusitis patients who receive antibiotics/nasal
steroid spray along with a course of oral steroids. The goal is to determine if oral steroids
have a role in CRSsNP, and if so, the most effective dosage.

Inclusion Criteria:

1. They have three-months of persistent symptoms meeting criteria for chronic
rhinosinusitis as defined by the taskforce on rhinosinusitis.

2. They have a CT-scan in the clinic or have a viewable recent (< 3 weeks prior to clinic
visit) CT-scan with a Lund Mackay score of 6 or greater. A Lund Mackay score of 6 or
greater is felt to be indicative of at least moderate CRS.

3. They do not have nasal polyps on initial clinic nasal endoscopy

4. They are willing to participate in a clinical study

5. They are between the ages of 18 to 80.

Exclusion Criteria:

1. They have a condition in which the use of systemic corticosteroids is contraindicated
such as diabetes will be excluded.

2. They are unable to or unwilling to take the prescribed antibiotics or steroids will
excluded.

3. They have been treated with a > 3 week course of antibiotics and/or systemic steroids
will also be excluded.

4. They have variants of chronic sinusitis known to be refractory to medical therapy such
as Wegener's granulomatosis, primary ciliary dyskinesia or sarcoidosis.

5. They have sinusitis secondary to prior surgery, a dental procedure or anatomical
variants.

6. They have nasal polyps on physical exam.

7. They are pregnant. Subjects who are possibly pregnant will be excluded based on
history. Pregnancy testing is not standard of care for diagnostic imaging.

8. They have a Lund-Mackay score on CT scan of < 6

9. They are < 18 or > 80 years old