European Position Paper on Rhinosinusitis and Nasal Polyps 2020

Abstract

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, 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. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.

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Affiliated Institutions

• University of Southern Denmark DK
• Helsinki University Hospital FI
• Copenhagen University Hospital DK
• Zentrum für Rhinologie und Allergologie DE
• Sisters of Charity Hospital HR
• Gulf Research Center CH
• Ivano-Frankivsk National Medical University UA
• Kilimanjaro Christian Medical Centre TZ
• Vilnius University LT
• National University of Singapore SG
• University of Alabama at Birmingham US
• Iuliu Hațieganu University of Medicine and Pharmacy RO
• Charité - Universitätsmedizin Berlin DE
• St Thomas' Hospital GB
• Pontificia Universidad Católica del Ecuador EC
• Medical University of Graz AT
• Observational & Pragmatic Research Institute SG
• Rigshospitalet DK
• Macquarie University AU
• Northwestern University US
• The University of Queensland AU
• University of Antwerp BE
• Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech RU
• AHEPA University Hospital GR
• Zagreb School of Business HR
• CHU Dinant Godinne UCL Namur BE
• Makerere University UG
• Université de Montréal CA
• Hôpital Pellegrin FR
• WinnMed US
• KU Leuven BE
• Universiti Malaysia Sarawak MY
• University of Milan IT
• Juraj Dobrila University of Pula HR
• Sultan Qaboos University OM
• University Hospital Münster DE
• Royal National Throat Nose and Ear Hospital GB
• Leiden University Medical Center NL
• Pontificia Universidad Católica de Chile CL
• Hillel Yaffe Medical Center IL
• Universidad Nacional de Asunción PY
• University of Malta MT
• Skåne University Hospital SE
• Eye & ENT Hospital of Fudan University CN
• James Paget University Hospital GB
• King Saud University SA
• Université Paris-Est Créteil FR
• University of Ottawa CA
• University of Novi Sad RS
• Medical University of Warsaw PL
• First Pavlov State Medical University of St. Petersburg RU
• Bushehr University of Medical Sciences IR
• Ankara University TR
• Newcastle University GB
• Universitat de València ES
• Royal Brisbane and Women's Hospital AU
• Paracelsus Medical University AT
• Shimane University JP
• Amsterdam University Medical Centers NL
• Universidade de São Paulo BR
• University of Pennsylvania US
• American University of Beirut LB
• University of North Carolina at Chapel Hill US
• University Kebangsaan Malaysia Medical Centre MY
• Karolinska Institutet SE
• University of Edinburgh GB
• Hospital Clínic de Barcelona ES
• Università Cattolica del Sacro Cuore IT
• University of East Anglia GB
• Charles University CZ
• University of Beira Interior PT
• National University of Ireland IE
• University of Zagreb HR
• University of Helsinki FI
• Jordan University of Science and Technology JO
• Universitat de Barcelona ES
• Oregon Health & Science University US
• Medical University of South Carolina US
• Hospital Quirónsalud Barcelona ES
• Omar Al-Mukhtar University LY
• Centro Hospitalar de Entre o Douro e Vouga E.P.E. PT
• Saints Cyril and Methodius University of Skopje MK
• Kyung Hee University KR
• APC Microbiome Institute IE
• Cairo University EG
• University of Sulaimani IQ
• Agostino Gemelli University Polyclinic IT
• Universidad de Antioquia CO
• Mayo Clinic in Florida US
• Lund University SE
• Comer Children's Hospital US
• Ghent University Hospital BE
• National University of Malaysia MY
• University of Insubria IT
• University of Banja Luka BA
• University Hospital of Geneva CH
• University of Auckland NZ
• Centre Hospitalier Universitaire de Bordeaux FR
• Mulago Hospital UG
• Beijing Tongren Hospital CN

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