الفهرس 
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Abstract
Chronic rhinosinusitis (CRS) is defined as inflammation of the nose and paranasal sinuses for more than 12 weeks. characterized by two or more symptoms. One of which should be nasal obstruction or nasal discharge. Confirmation of sinus-nasal mucosal inflammation via either endoscopic inspection or imaging is recommended to confirm the clinical diagnosis.
The signs and symptoms of CRS include Nasal obstruction which is the most common symptom, facial pressure-congestion-fullness, nasal discharge and hyposmia. High fever is usually absent, but myalgias and fatigue are common.
There is no one causative factor that accounts for CRS. There is evidence of numerous factors contributing to CRS as biofilms, osteitis, allergy, superantigens from Staphylococcus aureus, fungi, general host factors and infectious agent.
Management of CRS usually medical includes antibiotics, a nasal steroid spray and nasal saline irrigation. Other drugs may be added if no response. Surgical interference may be needed.
Vitamins D is very essential to be in our diet. The major role of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D may also protect against osteoporosis, cancer and other diseases.
The ability of Vitamin D3 to augment innate and adaptive immune responses has sparked interest in its immunologic role in allergy.
The vitamin D deficiency in otorhinolaryngology (ORL) has been attributed to cochlear deafness, Meniere’s disease and otosclerosis including cochlear otosclerosis.
In our meta-analysis, 6 articles were included with a total number of participants of 309 [control=86, chronic rhinosinusitis without nasal polyps (CRSsNP)=122 and chronic rhinosinusitis with nasal polyps (CRSwNP)=101] with vitamin D level and all were published between 2011 and 2016. A four comparisons were done using an appropriate statistically methods.
The 1st comparison showed that is no statistically difference in vitamin D level between CRSsNP and control group (p-value= 0.752).
The 2nd comparison showed that is a statistically difference in vitamin D level between CRSwNP and control group (p-value= 0.026) i.e. Vitamin D level are very low in CRSwNP in comparing with control group.
The 3rd comparison showed that is a statistically difference in vitamin D level between CRSwNP and CRSsNP (p-value= 0.001) i.e. Vitamin D level are very low in CRSwNP in comparing with CRSsNP group.
The 4th comparison showed that is no statistically difference in vitamin D level between CRS with or without NP and control group (p-value= 0.244).