EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

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 (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) 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. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

The Expression of ephrinA1/ephA2 Receptor Increases in Chronic Rhinosinusitis and ephrinA1/ephA2 Signaling Affects Rhinovirus-Induced Innate Immunity in Human Sinonasal Epithelial Cells

“…A total of 134 patients were enrolled; 25 patients were controls, 36 patients had CRS without nasal polyps (CRSsNP), and 73 had CRS with nasal polyps (CRSwNP) (35 non-eosinophilic, 38; eosinophilic) ( Supplementary Table 1 ). The patients were classified into CRSsNP or CRSwNP based on the diagnostic parameters outlined by the European Position Paper ( 1 ). Normal sinus mucosal sampling was conducted in the ethmoid sinus of patients with blowout fracture as a control and inflamed sinus mucosa was obtained from the ethmoid sinus of patients with CRS during surgery, respectively.…”

“…Chronic rhinosinusitis (CRS) is a heterogenous mucosal inflammation of the nasal cavity and paranasal sinuses ( 1 ). Although the pathophysiological causes of CRS remain unclear, accumulating evidence suggests that abnormal immune response of sinonasal mucosa to respiratory viral infection can progress to secondary bacterial infection and induce the exacerbation of CRS ( 2 – 6 ).…”

Elevated Serum Leptin Levels in Patients With Eosinophilic Chronic Rhinosinusitis

“…The diagnosis of sinus disease was made based on patient history, clinical examination, nasal endoscopy, and computed tomography (CT) of the sinuses according to the guidelines of the European Position Paper on Rhinosinusitis and NPs ( Fokkens et al, 2012 ). Patients with CRS were recruited before surgery, from the Department of Otorhinolaryngology, Head & Neck Surgery, University of Fukui, Fukui, Japan.…”

Cytokine Signature and Involvement in Chronic Rhinosinusitis with Nasal Polyps

“…Ig may play an important role in the inflammatory reaction of CRSwNP. IgA could make it possible to limit microbiological colonization [ 62 ] and IgD might intervene in the defense against respiratory bacteria [ 63 ]. Regarding the cytokine profile, IL-10 and TGF-β are involved in IgA switch and synthesis, and IL-4 in IgD synthesis [ 7 ].…”