EAACI Position Paper on Rhinosinusitis and Nasal Polyps Executive Summary

Autor: Fokkens, Wytske, Lund, Valerie, Bachert, Claus, Clement, Peter, Hellings, Peter, Holmstrom, Mats, Jones, Nick, Kalogjera, Livije, Kennedy, David, Kowalski, Marek, Malmberg, Henrik, Mullol, Joaquim, Passali, Desiderio, Stammberger, Heinz, Stierna, Pontus, EAACI
Rok vydání: 2005
Předmět:
Zdroj: Allergy. 60:583-601
ISSN: 1398-9995
0105-4538
DOI: 10.1111/j.1398-9995.2005.00830.x
Popis: OS document, initated by the Academy ofAllergology and Clinical Immunology (EAACI) andapproved by the European Rhinologic Society (ERS), isintended to be state-of-the art for the specialist as well asfor the general practitioner:• to update their knowledge of rhinosinusitis and nasalpolyposis;• to provide an evidence-based documented revision ofthe diagnostic methods;• to provide an evidence-based revision of the availabletreatments;• to propose a stepwise approach to the management ofthe disease;• to propose guidance for definitions and outcomemeasurements in research in different settings.This executive summary focuses on definitions, diagnosisand treatment and the relation to allergy and lowerairway disease. The whole document is published at theEAACI website (http://www.eaaci.org) and in the JournalRhinology (Supplement 18, March 2005).Definition of rhinosinusitis/nasal polypsRhinitis and sinusitis usually coexist and are concurrentin most individuals; thus, the correct terminology is nowrhinosinusitis.In 2001 the WHO put together a working group onrhinitis and its impact on asthma (ARIA) (9). In thisgroup rhinitis was classified according to duration andseverity. Because rhinitis and sinusitis are so closelylinked the definition of CRS/NP in the EPOS document isdeveloped from the ARIA classification of rhinitis andbased on symptomatology, duration and severity ofdisease.The diagnosis of rhinosinusitis is made by a widevariety of practitioners, including allergologists, otolar-yngologists, pulmonologists, primary care physicians andmany others. Due to the large differences in technicalpossibilities to diagnose and treat rhinosinusitis/nasalpolyps by various professions, definitions of CRS/NPshould be tailored to the individual group.Clinical definition of rhinosinusitis/nasal polypsRhinosinusitis (including nasal polyps) is defined as:• Inflammation of the nose and the paranasal sinusescharacterised by two or more symptoms:– blockage/congestion– discharge: anterior/post nasal drip– facial pain/pressure– reduction or loss of smelland either• Endoscopic signs:– polyps– mucopurulent discharge from middle meatus– oedema/mucosal obstruction primarily in middlemeatusand/or• CT changes:– mucosal changes within ostiomeatal complex and/or sinusesSeverity of disease. The disease can be divided intoMILD and MODERATE/SEVERE based on total visualanalogue scale (VAS) score (0–10 cm): MILD ¼ VAS0–4, MODERATE/SEVERE ¼ VAS 5–10.To evaluate the total severity the patient is asked toindicate on a VAS the question:How troublesome are your symptoms of rhinosinusitis?Not troublesome Most troublesome
Databáze: OpenAIRE
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