This research study will be completed by enrolling a prospective, observational cohort study to evaluate medical versus surgical treatment outcomes for chronic sinus disease. This investigation will compare quality of life outcomes between each treatment type, as well as measure cellular and molecular markers of inflammation in the sinus mucosa, to create models that predict improvement in quality of life following treatment.

Inclusion Criteria:

• Adult (>= 18 years)
• Chronic rhinosinusitis as defined by the 2007 multi-disciplinary adult sinusitis guidelines
• Able to complete all surveys/questionnaires in English
• Persistent symptoms following initial medical management
• Received at least 1 course of broad spectrum antibiotics or culture directed antibiotics for at least a total of 14 days
• Received at least a 3 week trial of topical steroid sprays OR at least a 5 day trial of systemic corticosteroid therapy.
• Counseled for subsequent treatment options including either medical management or endoscopic sinus surgery

Exclusion Criteria:

• Children (<18 years)
• Unable to complete all surveys/questionnaires at baseline

Adult patients who have failed intial medical management for chronic sinusitis and have presented to a tertiary care clinic for continued treatment.