Impact of Budesonide Irrigations on Patients With Chronic Rhinosinusitis and Impact on Sinus Surgery Rates

Inclusion Criteria: * adult (\>18 yo) * symptoms consistent with sinusitis for at least 12 weeks, * undergone maximal medical therapy, including: extended course of antibiotics (21 days minimum), use of topical corticosteroids for a minimum of 6 weeks, use of saline rinses at least once a day for a minimum of 3 weeks * CT showing evidence of chronic sinusitis. Exclusion Criteria: * pregnant women, * age below 18, * presence of nasal polyps or other nasal masses, * failure to complete medical therapy, * normal CT scan, * intolerance to budesonide or saline irrigations via squeeze bottle (high volume, high flow).