Acute and Chronic Sinusitis

Which radiological finding on CT paranasal sinuses is diagnostic of chronic rhinosinusitis according to the Lund-Mackay staging system?

A 35-year-old man from Delhi presents with a 3-week history of purulent nasal discharge, facial pain over the cheeks, and fever. Nasal endoscopy shows pus in the middle meatus. CT PNS reveals opacification of the maxillary sinuses bilaterally with intact bony walls. He has already received 2 weeks of oral amoxicillin-clavulanate without improvement. What is the most appropriate next step in management?

A 35-year-old man from Delhi presents with a 3-week history of nasal obstruction, purulent nasal discharge, and facial pain over the cheeks. Examination reveals swelling and tenderness over the maxillary region. Which is the most common paranasal sinus involved in acute sinusitis?

Which clinical feature best distinguishes acute bacterial sinusitis from acute viral rhinosinusitis in a 32-year-old patient presenting with nasal congestion and facial pain?

Which radiological and clinical feature best distinguishes chronic rhinosinusitis with nasal polyps (CRSwNP) from chronic rhinosinusitis without nasal polyps (CRSsNP) in a 45-year-old Indian male with 3-month history of nasal obstruction?