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Expert Consensus on Surgical Management of Primary Diffuse Type 2-Dominant Chronic Rhinosinusitis
Manon Blauwblomme1, Christos Georgalas2,3, Shahzada Ahmed4
1Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
International Forum of Allergy & Rhinology
|February 10, 2025
Summary
This study provides surgical guidelines for type 2 chronic rhinosinusitis (CRS). Consensus was reached on 45 statements for managing CRS surgery, emphasizing complete sinus surgery.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Chronic rhinosinusitis (CRS) presents surgical management challenges, especially for type 2 CRS.
- Lack of clear guidelines complicates treatment for type 2 CRS.
- This review addresses surgical strategies for primary diffuse type 2-dominant CRS.
Purpose of the Study:
- To establish consensus-based guidelines for surgical management of primary diffuse type 2-dominant CRS.
- To define preoperative and intraoperative strategies for CRS surgery.
- To provide evidence and expert opinion for clinical decision-making.
Main Methods:
- Modified Delphi method employed by an international expert consensus group.
- Literature review followed by formulation and iterative refinement of 67 statements.
- Consensus meeting held in Santorini, Greece, in October 2023 to finalize recommendations.
Main Results:
- Consensus achieved on 45 out of 68 proposed statements.
- Recommendations cover indications, timing, extent, and intraoperative management for CRS surgery.
- Emphasis on complete sinus surgery, including neo-sinus cavity creation and polyp/mucosa clearance.
Conclusions:
- 45 consensus statements offer guidance for surgical management of primary diffuse type 2-dominant CRS.
- Guidelines integrate current evidence and expert opinion.
- Recommendations support complete sinus surgery prior to monoclonal antibody therapy when appropriate.
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