Exploring Diagnosis and Treatment of Non-Eosinophilic Chronic Rhinosinusitis

Monday, October 13, 2025

1:00 PM - 2:00 PM EDT

Location: Wabash Ballroom 2

Disclosure(s):

Martin J. Citardi, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

William C. Yao, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michael J. Marino, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Over the past 5 years, chronic rhinosinusitis (CRS) treatment has been revolutionized by the introduction of biologics that target specific pathways of type 2 inflammation. While these type 2 inflammatory pathways are common in CRS, CRS itself is a heterogeneous syndrome of specific subtypes that share phenotypic features, but differ in underlying patho-etiologic mechanisms. In this panel presentation, we will explore those CRS subtypes that are not driven by type 2 inflammation. These CRS subtypes are often difficult to recognize, and their treatments, while well described in the literature, are not commonly discussed. In short, we will look for options for those patients with non-eosinophilic CRS who are failing initial treatments.
Specific CRS subtypes include odontogenic CRS, macrolide-responsive CRS, chronic infection, and vasculitis. These CRS subtypes are encountered in the general ENT patient population, but often are diagnosed late. Thus, highlighting these CRS subtypes is important for all ENT physicians who treat nose and sinus conditions.
In other instances, the features of non-eosinophilic inflammation are not specific to a well-defined CRS subtype. This panel will also discuss a pragmatic approach for diagnosis and management.
Specific cases will illustrate the relevant diagnostic clues for each condition, and then treatment options will be described. Panelists will discuss tips that can be applied at the point-of-care. The case discussion will be supported through focused presentations of the published clinical reports and studies as well as consensus statements. The appropriate work-up, including laboratory testing and imaging, will be described. In addition, a framework for approaching non-eosinophilic CRS subtypes will be presented.

OUTCOME OBJECTIVE 1: Define difficult-to-treat, non-eosinophilic chronic rhinosinusitis (CRS)

OUTCOME OBJECTIVE 2: Diagnose CRS subtypes, including odontogenic, macrolide-responsive, vasculitis and infection

OUTCOME OBJECTIVE 3: Select and monitor treatments for these CRS subtypes

BACKGROUND STATEMENT: This panel will explore non-eosinophilic chronic rhinosinusitis (CRS) subtypes , which are difficult to recognize and treat. We will explore diagnostic and treatment options for these patients through case presentations and literature review.

Comprehensive Otolaryngology Track Statement :

Moderator(s)

Martin J. Citardi, MD

Professor & Chair
University of Texas-McGovern Medical School
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

William C. Yao, MD

Associate Professor
UTHealth Houston
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Michael J. Marino, MD

Associate Professor and Program Director, Department of Otolaryngology - Head & Neck Surgery
Mayo Clinic
Phoenix, AZ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AL

Amber U. Luong, MD, PhD

Professor and Vice Chair for Academic Affairs
University of Texas McGovern Medical School
Houston, TX, United States

Disclosure information not submitted.