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European Position Paper on Rhinosinusitis and Nasal Polyps 2012
Wytske J Fokkens1, Valerie J Lund, Joachim Mullol
1Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands.
Insights
The 2012 European Position Paper updates guidelines for rhinosinusitis and nasal polyps, offering refined definitions and evidence-based management strategies for acute and chronic conditions in children and adults.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Respiratory Medicine
Background:
- The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) provides evidence-based guidelines.
- Previous iterations were published in 2005 and 2007.
- An updated comprehensive review is necessary to reflect current knowledge.
Purpose of the Study:
- To provide an updated evidence-based guideline for the diagnosis and management of rhinosinusitis and nasal polyps.
- To refine definitions and classifications, including difficult-to-treat cases and pediatric rhinosinusitis.
- To present updated management strategies based on the latest scientific evidence.
Main Methods:
- Systematic review and analysis of existing evidence on rhinosinusitis and nasal polyps.
- Development of new definitions for disease control and difficult-to-treat rhinosinusitis.
- Inclusion of extensive chapters on epidemiology, pathophysiology, and predisposing factors.
Main Results:
- Introduced refined definitions for rhinosinusitis, including pediatric cases and difficult-to-treat conditions.
- Differentiated between chronic rhinosinusitis with and without nasal polyps regarding pathophysiology and treatment.
- Presented comprehensive analyses of epidemiological data, inflammatory mechanisms, and diagnostic approaches.
Conclusions:
- The 2012 EPOS provides updated, evidence-based recommendations for rhinosinusitis and nasal polyps.
- Emphasizes distinct approaches for acute versus chronic rhinosinusitis and differentiates management for CRS with and without nasal polyps.
- Offers revised management schemes for both adult and pediatric populations, incorporating new insights into genetics, comorbidities, and upper/lower airway interactions.
Abstract:
The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, 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. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.
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