European Position Paper on Rhinosinusitis and Nasal Polyps 2020
W.J. FokkensDepartment of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The NetherlandsValerie J. LundRoyal National Throat, Nose and Ear Hospital, UCLH, London, UKC. HopkinsEar, Nose and Throat Department, Guys and St. Thomas Hospital, London, United KingdomPeter W. HellingsDepartment of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The NetherlandsRobert C. KernDepartment of Otorhinolaryngology - Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USASietze ReitsmaDepartment of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The NetherlandsSanna Toppila‐SalmiSkin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, FinlandManuel Bernal‐SprekelsenDepartment Hospital Quironsalud, University of Valencia, Valencia, SpainJ MullolIsam AlobidRhinology and Skull Base Unit, ENT Department, Hospital Clinic de Barcelona, Universidad de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, SpainWilma Terezinha Anselmo‐LimaDivision of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, BrazilClaus BachertDivision of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, SwedenFuad M. BaroodyDepartment of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children's Hospital, Chicago, IL, USAChristian von BuchwaldDepartment of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Hospital, Copenhagen, DenmarkAnders CervinDepartment of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's HospitalNatalie R. CohenDepartment of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USAJ. Constantinidis1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, GreeceL. de GaboryRhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU de Bordeaux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, FranceMartin DesrosiersDepartment of ORL-HNS, Universite de Montreal, Montreal, CanadaZuzana DiamantAffiliate to Charles University, Dept of Respiratory Diseases, in Prague, Czech RepublicRichard DouglasDepartment of Surgery, The University of Auckland, Auckland, New ZealandPhilippe GevaertDepartment of Otorhinolaryngology, Ghent University, Ghent, BelgiumAnne‐Sophie HafnerUniversity of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, CroatiaRichard J. HarveyRhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, AustraliaGuy JoosDepartment of Respiratory Medicine, Ghent University Hospital, Ghent, BelgiumLivije KalogjeraENT Department, Zagreb School of MedicineAndrew KnillJanwillem KocksDepartment of Inhalation Medicine, Observational Pragmatic Research Institute, SingaporeBasile N. LandisRhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, SwitzerlandJacqueline LimpensMedical Information Specialist, Medical Library, Amsterdam University Medical Centres, location AMC, Amsterdam, The NetherlandsSarah LebeerDepartment of Bioscience Engineering, University of Antwerp, Antwerp, BelgiumOlga LourençoFCS - UBI Faculty of Health Sciences, University of Beira Interior, Covilha, PortugalP.M. MatricardiDepartment of Pediatric Pneumology and Immunology, Charite - Universitatsmedizin Berlin, Berlin, GermanyCem MeçoDepartment of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, TurkeyLiam O’MahonyDepartments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, IrelandCarl PhilpottDepartment of Medicine, Norwich Medical School, University of East Anglia, Norwich, UKDermot RyanAllergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UKRalf G.M. SchlösserDepartment of Otorhinolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, USABrent A. SeniorUNC Otorhinolaryngology / Head and Neck Surgery, Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery and Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, USATimothy L. SmithDivision of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head Neck Surgery, Oregon Health and Science University, Portland, OR, USAThijs TeelingPeter Valentin TomazicDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, AustriaD.Y. WangDepartment of Otorhinolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDe Yun WangDepartment of Otorhinolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeL ZhangDepartment of Otorhinolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, ChinaAdrian M. AgiusDepartment of Medicine and Surgery in the University of MaltaCecilia Ahlström‐EmanuelssonENT-Department, Lund University, SwedenRashid bin Yahya Al-AbriENT Division, Surgery Department, College of Medicine and Health and Sciences, Sultan Qaboos University, Muscat, OmanSilviu AlbuDepartment of Otorhinolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaSaied AlhabashDepartment of ENT, Medcare UAE, DubaiAleksandra AleksićENT Department, University Clinical Centre, University of Banja Luka, Bosnia and HerzegovinaMohammad AloulahENT Department, King Saud University, Riyadh, Kingdom of Saudi ArabiaMohannad Al‐QudahDepartment of Otorhinolaryngology, Jordan University of Science and Technology, Irbid, JordanSaad AlsalehDepartment of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi ArabiaMuaid I. Aziz BabanDepartment of Otorhinolaryngology - Head and Neck Surgery, University of Sulaimani, Sulaimayniha, IraqTomislav BaudoinDept. of ORL-HNS Sisters of Mercy University Medical Center, School of Medicine University of Zagreb, CroatiaT BalversDepartment of Neurology, Leiden University Medical Center (LUMC)Paolo BattagliaDivision of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, ItalyDavid BedoyaDepartment of Otorhinolaryngology, Universidad de Antioquia, Medellin, ColombiaAchim G. BeuleDepartment of Otorhinolaryngology, University Clinic of Munster, GermanyKhaled Mohamed BofaresDepartment of Otorhinolaryngology, Omar Al-Moukhtar University, Albyeda, LibyaIrwin M. BravermanDepartment of Otorhinolaryngology - Head and Neck Surgery, Hillel Yaffe Medical Center, IsraelEliza Brożek-MądryDepartment of Otorhinolaryngology, Medical University of Warsaw, PolandB RichardDepartment of ENT, Makerere University, Kampala, UgandaC. A. CallejasDepartment of Otorhinolaryngology, Pontificia Catholic University, Santiago, ChileSean CarrieDepartment of Otorhinolaryngology, Head and Neck Surgery, Newcastle University, United KingdomLisa CaulleyDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, CanadaDesderius ChussiDepartment of Otorhinolaryngology, Kilimanjaro Christian Medical University College, Moshi, TanzaniaEugenio De CorsoDepartment of Otorhinolaryngology , La Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, ItalyA. CosteORL et Chirurgie Cervico-Faciale, Universite Paris-Est Creteil (UPEC), FranceL. DevyaniDepartment of Otorhinolaryngology, American University of Beirut, LebanonUsamah HadiDepartment of Otorhinolaryngology, American University of Beirut, LebanonAhmaed ElfaroukDepartment of Otorhinolaryngology, Cairo University, EgyptP.H. EloyDepartment of ENT, CHU UCL Namur, Yvoir, BelgiumShokrollah FarrokhiDepartment of Immunology and Allergy, The Persian Gulf Tropical Medicine Research CenterGiovanni FelisatiDepartment of Head and Neck, University of Milan, ItalyM.D. FerrariDepartment of Neurology, Leiden University Medical Center (LUMC)Roman FishchukDepartment of ENT- Organs Microsurgery, Central city clinical hospital of lvano-Frankivsk city council, Ivano-Frankivsk, UkraineJ.W. GraysonENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PortugalP.M. GoncalvesENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PortugalBoris GrdinićENT Department, General Hospital, Pula, Pula, CroatiaV GrgicENT Department, Zagreb School of MedicineA.W. HamizanDepartment of Otorhinolaryngology, University Kebangsaan, Kuala Lumpur, MalasyiaJ.V. HeinichenDepartment of ENT of Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, ParaguaySalina HusainDepartment of Otorhinolaryngology, Head and Neck Surgery, National University of Malaysia, Kuala Lumpur, MalaysiaT.I. PingDepartment ORLHNS, University Malaysia Sarawak, Kuching, MalaysiaJustinas IvaškaClinic of Ear, Nose, Throat and Eye diseases, Vilnius University, LithuaniaFrodita JakimovskaENT Department of Medical Faculty, St Cyril and Methodius University of Skopje, North MacedoniaLjiljana JovančevićDepartment of Otorhinolaryngology, Head and Neck Surgery, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, SerbiaEmily KakandeDepartment of ENT Surgery, Mulago National Referral Hospital Kampala, UgandaRasha KamelDepartment of Otorhinolaryngology, Head and Neck Surgery, Cairo University, EgyptSergey KarpischenkoENT Department, Director of Saint Petersburg Research Institute of Ear, Throat , Nose and SpeechH.H. KariyawasamDepartment of Allergy and Clinical Immunology, Royal National ENT Hospital, London, EnglandJens KjeldsenDepartment of Otorhinolaryngology, Head and Neck Surgery, University of Southern Denmark, Odense, DenmarkL. KlimekCenter of Rhinology and Allergology, Wiesbaden, Hesse, GermanyS.W. KimDepartment of Otorhinolaryngology, Head and Neck Surgery, Kyung Hee University, Seoul, South KoreaJ.J. LetortDepartment of Otorhinolaryngology, Pontifica Catholic University of Ecuador, Quito, EcuadorLopatin AsDepartment of Otorhinolaryngology, Policlinic No.1- Senior ENT Consultant and SurgeonA MahdjoubiClinique Mahabi, Setif, AlgeriaJ NetkovskiDepartment of Otorhinolaryngology-Head and Neck Surgery, St. Cyril and Methodius, Skopje, Republic of North Macedonia
2020en
ABI
Аннотация
Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we can make progress with research in this area. Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Rhinosinusitis (including nasal polyps) is defined as inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip), +/- facial pain/pressure, +/- reduction or loss of smell; and either endoscopic signs of polyps and/or mucopurulent discharge primarily from middle meatus and/or; oedema/mucosal obstruction primarily in middle meatus, and/or CT changes showing mucosal changes within the ostiomeatal complex and/or sinuses. The paper gives different definitions for epidemiology, first line and second line treatment and for research. Furthermore the paper describes the anatomy and (patho)physiology, epidemiology and predisposing factors, inflammatory mechanisms, evidence based diagnosis, medical and surgical treatment in acute and chronic rhinosinusitis and nasal polyposis in adults and children. Evidence based schemes for diagnosis and treatment are given for the first and second line clinicians. Moreover attention is given to complications and socio-economic cost of chronic rhinosinusitis and nasal polyps. Last but not least the relation to the lower airways is discussed.
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