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

• They have three-months of persistent symptoms meeting criteria for chronic rhinosinusitis as defined by the taskforce on rhinosinusitis.
• 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.
• They do not have nasal polyps on initial clinic nasal endoscopy
• They are willing to participate in a clinical study
• They are between the ages of 18 to 80.

Exclusion criteria

• They have a condition in which the use of systemic corticosteroids is contraindicated such as diabetes will be excluded.
• They are unable to or unwilling to take the prescribed antibiotics or steroids will excluded.
• They have been treated with a > 3 week course of antibiotics and/or systemic steroids will also be excluded.
• They have variants of chronic sinusitis known to be refractory to medical therapy such as Wegener's granulomatosis, primary ciliary dyskinesia or sarcoidosis.
• They have sinusitis secondary to prior surgery, a dental procedure or anatomical variants.
• They have nasal polyps on physical exam.
• They are pregnant. Subjects who are possibly pregnant will be excluded based on history. Pregnancy testing is not standard of care for diagnostic imaging.
• They have a Lund-Mackay score on CT scan of < 6
• They are < 18 or > 80 years old