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International consensus statement on rhinosinusitis

10 University of Toronto 11 Northwestern University

42 University of Colorado 43 University of Virginia 44 Massachusetts Eye & Ear 45 UCLA

12 Rajavithi Hospital 13 Konkuk University 14 University of Alberta 15 University of Washington 16 Oregon Health and Science University 17 Emory University 18 University of Southern California 19 University of Auckland 20 Oregon Health and Science University 21 University of Utah 22 Amsterdam University Medical Centres 23 Weill Cornell Medicine 24 Sun yat-sen University 25 Rutgers New Jersey Medical School 26 Capital Medical University 27 Keck School of Medicine, University of Southern California 28 Hackensack Meridian School of Medicine 29 University of Washington 30 Weill Cornell Medicine 31 Chulalongkorn University 32 Northwestern University, Feinberg School of Medicine 33 University of Pennsylavnia 34 Kaiser Permanente 37 Hospital Clinic, University of Barcelona, Spain 38 Kaiser Permanente Oakland Medical Center 39 Taichung Veterans General Hospital 40 Johns Hopkins University 41 Ramón y Cajal University Hospital 35 University of California at Irvine 36 Taipei Veterans General Hospital

46 Medikeri’s Superspeciality ENT Center 47 Medical University of South Carolina 48 Uniformed Services University of Health Sciences 49 Rush University Medical Center 50 Catholic University of Sacred Heart 51 University of Cincinnati College of Medicine

52 Northwestern University 53 Mayo Clinic in Arizona 54 University of Auckland 55 Johns Hopkins

56 University of Chicago 57 Harvard Medical School 58 Northwestern University, Feinberg School of Medicine 59 King Chulalongkorn Memorial Hospital 60 Rush University Medical Center 61 Ribeirao Preto Medical School, University of Sao Paulo 62 University of Exeter Medical School 63 Ribeirao Preto Medical School, University of Sao Paulo 64 Emory University 65 Harvard Medical School 66 Sinus and Nasal Specialists of Louisiana 67 Stanford University 68 University of Calgary 69 University of Auckland 70 University of Manitoba 71 University of California San Diego 72 University of Calgary 73 Cedars Sinai Medical Center 74 University of California San Diego 75 University of Texas Medical School at Houston

Correspondence Richard R. Orlandi, MD, 50 North Medical Drive, Salt Lake City, UT 84132 Email: richard.orlandi@hsc.utah.edu

I. Executive Summary Background: The 5 years since the publication of the first International Con sensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has wit nessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics cov ered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. Methods: ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Addition ally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. Conclusion: This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS. KEYWORDS rhinosinusitis, chronic rhinosinusitis, acute rhinosinusitis, recurrent acute rhinosinusitis, evidence-based medicine, systematic review, endoscopic sinus surgery