Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy

Bhattacharyya, Neil; Lee, Linda N.

doi:10.1016/j.otohns.2010.04.012

Cited by 122 publications

(130 citation statements)

References 19 publications

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“…655,656 Evidence has shown combining 2 or more symptoms together along with objective findings of disease (imaging, endoscopy) substantially increases diagnostic specificity and positive predictive value. 9,15,657 Although the original guidelines used major and minor criteria, 11 there has been no consensus or evidence whether this categorization is based on prevalence, sensitivity, or specificity of symptoms. As a result, the present definition includes the most sensitive symptoms as part of the diagnosis.…”

Section: Viid Crssnp: Diagnosismentioning

confidence: 99%

“…Prior studies comparing symptoms against a CT gold standard have suggested the specificity of symptoms in the range of 2% to 12% and positive predictive values ranging between 35% and 54%. 7,655,657 r Aggregate Grade of Evidence: B (Level 2b: 8 studies;…”

Section: Because Of Limited Data Crswnp and Crssnp Are Combined In Tmentioning

confidence: 99%

“…In postsurgical patients, the surgical alterations of the anatomy also facilitate a thorough examination of the sinuses using nasal endoscopy alone. Bhattacharyya and Lee 657 determined that compared to using a symptom-based criteria alone to predict the presence of CRS (specificity and positive predictive value of 12% and 39%, respectively, using a CT-based gold standard), the addition of nasal endoscopy to a symptom-based assessment substantially increases the diagnostic accuracy of CRS, with specificity and positive predictive values estimated at 84% and 66%, respectively.…”

Section: Viid2b Crs Diagnosis With Nasal Endoscopymentioning

confidence: 99%

“…676 Alternatively, a negative endoscopy in a symptomatic patient also decreases the likelihood of CRS to about 20%. 657,676 Therefore, although nasal endoscopy entails significant upfront costs related to the purchase, maintenance, and processing of equipment along with the expertise of specialists, the evidence supports its use as a cost-effective strategy related to potentially avoiding the need to obtain a CT scan of the sinuses.…”

Section: Viid2b Crs Diagnosis With Nasal Endoscopymentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

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557

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: Viid Crssnp: Diagnosismentioning

confidence: 99%

Section: Because Of Limited Data Crswnp and Crssnp Are Combined In Tmentioning

confidence: 99%

Section: Viid2b Crs Diagnosis With Nasal Endoscopymentioning

confidence: 99%

Section: Viid2b Crs Diagnosis With Nasal Endoscopymentioning

confidence: 99%

See 2 more Smart Citations

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

Self Cite

557

888

View full text Add to dashboard Cite

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“…Chronic rhinosinusitis (CRS) is a common disease of the nasal cavity and sinuses that affects millions of people worldwide (1). CRS can be divided into two subtypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) (2).…”

Section: Introductionmentioning

confidence: 99%

Different roles of Staphylococcus aureus enterotoxin in different subtypes of nasal polyps

Cheng

Wang

2016

Experimental and Therapeutic Medicine

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Abstract. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease. The pathogenesis of CRSwNP remains unclear. This study was designed to investigate the role of inflammation and Staphylococcus aureus enterotoxin (SE) in this disease. The study included a total of 74 patients with CRSwNP and 6 controls. A serum Phadiatop assay was conducted to detect atopy status, and serum eosinophil cationic protein (ECP) and total immunoglobulin (Ig)E levels were determined using ELISA. SEA, SEB, total IgE, ECP and myeloperoxidase (MPO) levels in nasal tissue supernatant were measured using ELISA. The results indicated that 15 (22.1%) patients had systemic allergies. On the basis of the ECP/MPO ratio, the patients were divided into an eosinophilic CRSwNP group (n=18) and a non-eosinophilic CRSwNP group (n=56). The total ECP/MPO ratio was 0.572, with a notable bias toward neutrophilic inflammation. The supernatant ECP and MPO levels were elevated in the CRSwNP group compared with the control group, but no significant difference in the serum total IgE and ECP levels were observed between the CRSwNP and control groups. In addition, the non-eosinophilic and eosinophilic CRSwNP groups showed significant elevations in supernatant total IgE, SEA and SEB levels compared with the control group. Thus, it may be concluded that allergy is a common pathogenesis of CRSwNP, and neutrophilic inflammation is present in most Chinese CRSwNP patients. Additionally, local indicators reflect the inflammatory status more accurately than do serum indicators. SEs may act as an infection factor rather than as a superantigen in Chinese non-eosinophilic CRSwNP patients. Thus, long-term antibiotic therapy may be an option for Chinese non-eosinophilic CRSwNP patients.

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Factors associated with computed tomography status in patients presenting with a history of chronic rhinosinusitis

Abrass

Chandra

Conley

et al. 2011

Int Forum Allergy Rhinol

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Evaluating the diagnosis of chronic rhinosinusitis based on clinical guidelines and endoscopy

Abstract: In patients meeting current guideline symptom criteria for CRS, the addition of nasal endoscopy improves diagnostic accuracy and should be emphasized as an early diagnostic tool. Diagnostic endoscopy may help reduce the use of CT, reducing costs and radiation exposure.

Cited by 122 publications

References 19 publications

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Different roles of Staphylococcus aureus enterotoxin in different subtypes of nasal polyps

Factors associated with computed tomography status in patients presenting with a history of chronic rhinosinusitis

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