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Evaluation of the Medical and Surgical Treatment Of Chronic Rhinosinusitis: A Prospective, Randomized, Controlled Trial Laryngoscope,114:923-930, 2004 Sameh M. Ragab, et al. Presented by Ri 林巧宜/Instructed by VS. 許巍鐘 VS. 許巍鐘 Objectives: To evaluate and compare the medical and surgical treatment of polypoid and nonpolypoid chronic rhinosinusitis (CRS). Inclusion Criteria: 8 weeks or greater of persistent symptoms and signs Meet 2 of 5 major symptom criteria headache facial pain pressure nasal congestion or obstruction nasal discharge olfactory disturbance 4 times/yr of recurrent acute rhinosinusitis ( 10 days) Persistent changes on CT for weeks after medical therapy Exclusion criteria: Pregnancy or lactation Significant psychologic problems Inability to comply with study protocol Children under 18 years of age Systemic diseases affecting the nose Use of systemic corticosteroids Systemic diseases preventing participation in the study Medical or surgical treatments influencing the study Methods: Subjective Assessment -Visual analogue scale Quality of life instruments -Sinonasal outcome test-20 (SNOT-20) -Short form 36 health survey (SF-36) Examination of the nose - Endoscopy Objective measurements -Nitric oxide -Acoustic rhinometry -Saccharine clearance test Methods(2): Medical Treatment --Initial medical treatment --Medical treatment for the medically randomized group --Medical treatment after surgery Surgical Treatment --Endoscopic sinus surgery Medical Treatment 1. Initial medical treatment. 1. 6-week regimen of Dexarhinaspray (DRS) (20 µg of dexamethasone-21-isonicotinate (a topical corticosteroid) and 120 µg of tramazoline hydrochloride (a topical decongestant) and an alkaline nasal