When It's Snot Chronic Rhinosinusitis: Systemic Causes of Sinus Disease

PROGRAM DESCRIPTION: Although chief complaints of nasal symptoms naturally evoke a differential diagnosis with primary sinonasal disorders at the top, there exist
systemic conditions that not only cause sinonasal symptomatology but also first present in this manner as secondary chronic rhinosinusitis.
These conditions can include immune mediated conditions (including granulomatous and vasculitis diseases) as well as immunodeficiency.
These conditions can lead to sinonasal symptoms that mimic or even cause primary sinonasal conditions such as chronic rhinitis or chronic and
recurrent rhinosinusitis. In these cases, a successful management plan requires diagnosis and treatment of the underlying systemic condition. A
failure to recognize systemic conditions as the cause of sinonasal symptomatology may lead to delays in diagnosis and appropriate treatment,
and unnecessary patient morbidity. In this expert lecture presentation we will present individual cases of patients with sinonasal manifestations
of systemic conditions (in the above-described categories). Discussion amongst the expert speakers will also provide unique and
complementary perspectives on diagnosis and treatment. Through discussion of cases, we will provide practical clinical insights by explaining
key signs and symptoms that can be used in the primary evaluation of the sinonasal patient to prompt early identification of an underlying
systemic condition. At the conclusion of each case presentation, we will 1) review the sinonasal manifestations of the specific condition and 2)
summarize practical clinical points regarding diagnosis and management. At the conclusion of the presentation, we will incorporate insights
provided by the speakers into an algorithm which attendees can implement in their own practices, for early identification of systemic conditions
that may be the underlying cause of common sinonasal symptoms.

OUTCOME OBJECTIVE 1: Have practical knowledge of the systemic conditions that can cause sinonasal symptomatology and secondary chronic rhinosinusitis.

OUTCOME OBJECTIVE 2: Recognize clinical signs and symptoms that would suggest the possibility of systemic conditions as the underlying cause of a patient’s sinonasal
symptomatology.

OUTCOME OBJECTIVE 3: Implement standard practices in their routine workup of sinonasal symptomatology that would raise the possibility of underlying systemic
conditions.

BACKGROUND STATEMENT: There is a need to recognize systemic conditions as the underlying cause of sinonasal symptomatology in order to prevent delays in diagnosis,
suboptimal treatment of the disease, and to prevent unnecessary morbidity to the patient.

Comprehensive Otolaryngology Track Statement :