Second was chronic rhinosinusitis (CRS),17, 18 defined by a more than 12-week history of 2 or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior, posterior, or both) with or without facial pain/pressure/fullness and reduction or loss of sense of smell. Patients with such symptoms were referred for nasal endoscopy and for computed tomographic scans to confirm paranasal sinus disease.