Despite recent advancements in both medical and surgical treatment for chronic rhinosinusitis (CRS), this condition still causes very significant morbidity and reduction of quality of life in those patients who suffer from it. If medical therapy fails to improve symptoms sufficiently then surgery is offered. However some patients experience persisting or recurrent symptoms after surgical intervention so there is scope to improve the efficacy of current perioperative care. There is however surprisingly limited scientific evidence on which to base a rational regimen of perioperative care. This article will review the currently available evidence, and highlight where deficiencies in our knowledge lie.