European Position Paper on Rhinosinusitis and Nasal Polyps 2007

Wytske Fokkens, Valerie Lund, Joaquim Mullol, Claus Bachert, Noam Cohen, Roxanna Cobo, Martin Desrosiers, Peter Hellings, Mats Holmstrom, Maija Hytönen, Nick Jones, Livije Kalogjera, David Kennedy, Jean Michel Klossek, Marek Kowalski, Eli Meltzer, Bob Naclerio, Desiderio Passali, David Brendan Price, Herbert RiechelmannGlenis Scadding, Heinz Stammberger, Michael David Thomas, Richard Voegels, De-Yun Wang, European Position Paper on Rhinosinusitis and Nasal Polyps Group

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Abstract

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.
Original languageEnglish
Number of pages135
JournalRhinology
Volume20
Issue numberSupplement
Publication statusPublished - 1 Jun 2007

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    Fokkens, W., Lund, V., Mullol, J., Bachert, C., Cohen, N., Cobo, R., Desrosiers, M., Hellings, P., Holmstrom, M., Hytönen, M., Jones, N., Kalogjera, L., Kennedy, D., Klossek, J. M., Kowalski, M., Meltzer, E., Naclerio, B., Passali, D., Price, D. B., ... European Position Paper on Rhinosinusitis and Nasal Polyps Group (2007). European Position Paper on Rhinosinusitis and Nasal Polyps 2007. Rhinology, 20(Supplement). http://www.rhinologyjournal.com/supplement_20.pdf