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As the sinonasal health of this patient population may have broad effects on pulmonary health and quality of life, a comprehensive understanding of the diagnostic and therapeutic approach to CF CRS is essential. In recognizing recent scientific advances and unique treatment modalities specific to this challenging patient population, in this review we systematically evaluate the scientific literature and provide an evidenced\u2010based review with recommendations (EBRR) for fundamental management principles of CF CRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was performed. Studies evaluating interventions for the management of CF CRS were included. An iterative review process was implemented in accordance with EBRR guidelines. A treatment recommendation was generated based on an assessment of the benefits, harms, and the overall grade of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated the published literature on 5 unique topics. Each of the following therapeutic categories was investigated explicitly for treatment outcomes in patients with CF CRS: (1) nasal saline; (2) intranasal corticosteroids (INCS); (3) topical antibiotics; (4) cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy; and (5) endoscopic sinus surgery (ESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the currently available evidence, nasal saline, ESS, and CFTR modulators are <jats:italic>recommended<\/jats:italic> in the management of CF CRS when appropriate. INCS and topical antibiotics are <jats:italic>options<\/jats:italic>. Clinical judgment and experience are essential in caring for patients with this uniquely challenging disorder.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22953","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T23:03:53Z","timestamp":1640127833000},"page":"1148-1183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The management of cystic fibrosis chronic rhinosinusitis: An evidenced\u2010based review with recommendations"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2602-0416","authenticated-orcid":false,"given":"Daniel B.","family":"Spielman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Columbia University Irving Medical Center  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8612-5442","authenticated-orcid":false,"given":"Daniel M.","family":"Beswick","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery David Geffen School of Medicine at UCLA  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Kimple","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery University of North Carolina School of Medicine  Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery University of North Carolina School of Medicine  Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Aanaes","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery &amp; Audiology University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3292-9167","authenticated-orcid":false,"given":"Bradford A.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery Brigham and Women's Hospital  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5173-8959","authenticated-orcid":false,"given":"Do\u2010Yeon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Alabama at Birmingham  Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania  Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"DiMango","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine Columbia University Irving Medical Center  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9349","authenticated-orcid":false,"given":"David A.","family":"Gudis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Columbia University Irving Medical Center  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199608000-00018"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.2905"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-3446-z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2016.03.004"},{"issue":"9","key":"e_1_2_7_6_1","first-page":"985","article-title":"Computed tomography (CT) scan findings of the paranasal sinuses in cystic fibrosis","volume":"103","author":"April MM","year":"1995","journal-title":"Am J Rhinol"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2010.01.001"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2013.10.011"},{"key":"e_1_2_7_9_1","unstructured":"GudisDA SchlosserRJ.The unified airway: Rhinologic disease and respiratory disorders. 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