A Pragmatic Approach Towards Sinonasal Diseases

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Primary Care Medicine

Background:

• Sinonasal diseases impact billions globally, posing a challenge for individual physician diagnosis and treatment.
• Current diagnostic and treatment pathways are insufficient for the vast number of affected individuals.

Purpose of the Study:

• To propose a pragmatic, tiered approach for managing sinonasal disease in primary care.
• To outline a safe and effective triage strategy based on initial treatment response.

Main Methods:

• Initial treatment with intranasal corticosteroids for two weeks.
• Triage based on patient-reported response to intranasal corticosteroids.
• Referral to specialists (allergists or otolaryngologists) for non-responders.

Main Results:

• Patients responding well can continue self-management.
• Patients not responding require further specialized evaluation.
• The approach is safe if primary care providers recognize red flags for serious conditions.

Conclusions:

• A two-week trial of intranasal corticosteroids offers a safe and pragmatic first-line management strategy for sinonasal disease.
• This approach facilitates efficient patient triage, reserving specialist care for those who need it.
• Awareness of warning signs for rare, severe sinonasal diseases is crucial for primary care providers implementing this strategy.