European Position Paper on Rhinosinusitis and Nasal Polyps 2020

Wytske J. Fokkens, Valerie J. Lund, Claire Hopkins, Peter W. Hellings, Robert Kern, Sietze Reitsma, Sanna Toppila-Salmi, Manual Bernal-Sprekelsen, Joaquim Mullol, Isam Alobid, Wilma Terezinha Anselmo-Lima, Claus Bachert, Fuad Baroody, Christian von Buchwald, Anders Cervin, Noam Cohen, Jannis Constantinidis, Ludovic De Gabory, Martin Desrosiers, Zuzana DiamantRichard G. Douglas, Philippe H. Gevaert, Anita Hafner, Richard J. Harvey, Guy F. Joos, Livije Kalogjera, Andrew Knill, Janwillem H. Kocks, Basile N. Landis, Jacqueline Limpens, Sarah Lebeer, Olga Lourenco, Cem Meco, Paolo M. Matricardi, Liam O'Mahony, Carl M. Philpott, Dermot Ryan, Rodney Schlosser, Brent Senior, Timothy L. Smith, Thijs Teeling, Peter Valentin Tomazic, De Yun Wang, Dehui Wang, Luo Zhang, Adrian M. Agius, Cecilia Ahlstrom-Emanuelsson, Rashid Alabri, Silviu Albu, Saied Alhabash, Aleksandra Aleksic, Mohammad Aloulah, Mohannad Al-Qudah, Saad Alsaleh, Muaid Aziz Baban, Tomislav Baudoin, Tijmen Balvers, Paolo Battaglia, Juan David Bedoya, Achim Beule, Khaled M. Bofares, Itzhak Braverman, Eliza Brozek-Madry, Richard Byaruhanga, Claudio Callejas, Sean Carrie, Lisa Caulley, Desderius Chussi, Eugenio de Corso, Andre Coste, Usama El Hadi, Ahmed Elfarouk, Philippe H. Eloy, Shokrollah Farrokhi, Giovanni Felisati, Michel D. Ferrari, Roman Fishchuk, Jessica W. Grayson, Paulo M. Goncalves, Boris Grdinic, Velimir Grgic, Aneeza W. Hamizan, Julio V. Heinichen, Salina Husain, Tang Ing Ping, Justinas Ivaska, Frodita Jakimovska, Ljiljana Jovancevic, Emily Kakande, Reda Kamel, Sergei Karpischenko, Harsha H. Kariyawasam, Hideyuki Kawauchi, Anette Kjeldsen, Ludger Klimek, Antoni Krzeski, Gabriela Kopacheva Barsova, Sung Wam Kim, Davyani Lal, Jose J. Letort, Andrey Lopatin, Abdelhak Mahdjoubi, Alireza Mesbahi, Jane Netkovski, Dieudonne Nyenbue Tshipukane, Andres Obando-Valverde, Mitsuhiro Okano, Metin Onerci, Yew Kwang Ong, Richard Orlandi, Nobuyoshi Otori, Kheir Ouennoughy, Muge Ozkan, Aleksandar Peric, Jan Plzak, Emmanuel Prokopakis, Nerayanan Prepageran, Alkis Psaltis, Benoit Pugin, Marco Raftopulos, Philippe Rombaux, Herbert Riechelmann, Semia Sahtout, Caius-Codrut Sarafoleanu, Kafui Searyoh, Chae-Seo Rhee, Jianbo Shi, Mahdi Shkoukani, Arthur K. Shukuryan, Marian Sicak, D. Smyth, Kornkiat Snidvongs, Tanja Soklic Kosak, Par Stjarne, Budi Sutikno, Sverre Steinsvag, Pongsakorn Tantilipikorn, Sanguansak Thanaviratananich, Thuy Tran, Jure Urbancic, Arunas Valiulius, Carolina Vasquez de Aparicio, Dilyana Vicheva, Paula M. Virkkula, Gil Vicente, Richard Voegels, Martin Wagenmann, Retno S. Wardani, Antje Welge-Lussen, Ian Witterick, Erin Wright, Dmytro Zabolotniy, Bella Zsolt, Casper P. Zwetsloot

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398 Citations (Scopus)

Abstract

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

Original languageEnglish
Pages (from-to)1-464
Number of pages464
JournalRhinology
Volume58
Issue numberSupplement 29
DOIs
Publication statusPublished - 20 Feb 2020

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