The American Academy of Otolaryngology – Head and Neck Surgery Foundation clinical practice guideline on adult sinusitis provides important evidence-based recommendations for clinical practitioners to effectively diagnose and treat patients with acute and chronic rhinosinusitis. The guideline was first published in 2007 and was last updated in 2015. Since 2015, however, significant advances in the understanding of the pathophysiology and clinical manifestations of specifically chronic rhinosinusitis (CRS) have resulted in modifications in the diagnostic workup, treatment strategies, and health counseling of patients. The recognition of phenotypes and endotypes in CRS, increased emphasis placed on the relationship between CRS and asthma, and introduction of biological therapies as treatment options for CRS are examples of the dynamic and evolving nature of CRS management. This panel discussion will provide a case-based approach to highlight differences between the 2015 guideline and current evidence-based strategies in the workup and treatment of CRS patients. Such a discussion will offer suggestions for quality improvements in the next iteration of the 2015 guideline.