New clinical practice guideline for surgical management of chronic rhinosinusitis in adults

The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) published the new Clinical Practice Guideline (CPG): Surgical Management of Chronic Rhinosinusitis today in Otolaryngology-Head and Neck Surgery.

Chronic rhinosinusitis (CRS) affects 11.6% of adults and prompts 4.1 million annual ambulatory visits.

"Chronic rhinosinusitis doesn't just affect the nose—it can influence a person's general life. Patients can struggle with poor sleep, brain fog, depression, anxiety, and reduced productivity that ripples through their relationships and work or school performance," said Jennifer J. Shin, MD, SM, Chair of the CPG Guideline Development Group.

"Many people don't realize that chronic rhinosinusitis can affect patients as much as diseases that have traditionally been viewed as life-threatening or more serious. Patients with CRS face daily challenges that deserve our full attention and comprehensive care. This CPG provides the guidance for developing the needed care pathways for patients who may undergo surgery for CRS, based on current best evidence, such as systematic reviews, meta-analyses, and randomized control trials, as well as observational studies when these were more apt for specific clinical research questions.”

CRS is diagnosed when a patient has two or more symptoms or signs of CRS for 12 weeks or longer, and inflammation is documented by one or more findings. The symptoms and signs include:

Thick and/or discolored drainage (from the front of the nose, down the back of the nose, or both),

Nasal obstruction (congestion),

Facial pain, pressure, and fullness, or

Decreased sense of smell

Some people with chronic sinus problems need surgery when medications alone don't provide enough relief. For certain types of sinus disease, having surgery sooner can help prevent worsening symptoms and reduce pain. Surgery works especially well for people who have fungal infections or nasal polyps (small growths), since these conditions often don't respond well to medication alone. Surgery may also help people whose sinus problems cause frequent infections, ongoing symptoms, or make other conditions like asthma worse.

This CPG provides proven, research-based recommendations for the best ways to treat chronic sinus problems. Specifically, through 11 evidence-based key action statements, it covers the main surgery and additional treatments that might be needed, as well as follow-up procedures when necessary. The goal is to ensure patients receive excellent care before, during, and after their sinus surgery, while making sure doctors clearly explain treatment options and involve patients in making informed decisions about their care.

The guideline development group consisted of 18 panel members representing experts in specialties/subspecialities encompassing rhinology, comprehensive otolaryngology, otolaryngic allergy, otorhinolaryngological advanced practice provision, as well as a consumer representative.

Members of the media who wish to request an interview or obtain a copy of the guideline should contact newsroom@entnet.org.

References: Betty S. Tsai Do MD, Matthew L. Bush MD, PhD, MBA, Heather M. Weinreich MD, MPH, Seth R. Schwartz MD, MPH, Samantha Anne MD, MS, Oliver F. Adunka MD, MBA, Kaye Bender PhD, RN, Kristen M. Bold MPAS, PA-C, Michael J. Brenner MD, Ardeshir Z. Hashmi MD, Teresa A. Keenan PhD, Ana H. Kim MD, Denée J. Moore MD, Carrie L. Nieman MD, MPH, Catherine V. Palmer PhD, Erin J. Ross DNP, APRN, Kristen K. Steenerson MD, Kevin Y. Zhan MD, Joe Reyes MS, Nui Dhepyasuwan MEd First published: 30 April 2024 https://doi.org/10.1002/ohn.750