xRead - Nasal Obstruction (September 2024) Full Articles

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238

International consensus statement on rhinosinusitis

X. Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) ..................................................................... 443 X.A. Incidence and Prevalence of CRSwNP ...................................................................................... 443 X.B. Diagnosis of CRSwNP ............................................................................................................ 443 X.B.1. Establishing the Diagnosis of CRSwNP ......................................................................... 443 X.B.2. Differential Diagnosis of CRSwNP ............................................................................... 443 X.B.3. Cost-Effective Work Up of CRSwNP ............................................................................ 447 X.C. Pathophysiology of CRSwNP ................................................................................................... 447 X.C.1. Associated Factors in CRSwNP: Asthma ....................................................................... 447 X.C.2. Contributing Factors for CRSwNP: Allergy ................................................................... 448 X.C.2.1 Central Compartment Atopic Disease ............................................................... 452 X.C.3. Contributing Factors for CRSwNP: Biofilms .................................................................. 457 X.C.4. Contributing Factors for CRSwNP: Fungus ................................................................... 458 X.C.5. Contributing Factors for CRSwNP: Neo-osteogenesis ..................................................... 458 X.C.6. Contributing Factors for CRSwNP: Gastroesophageal Reflux .......................................... 459 X.C.7. Contributing Factors for CRSwNP: Vitamin D Deficiency ............................................... 459 X.C.8. Contibuting Factors for CRSwNP: Superantigens .......................................................... 460 X.C.9. Contributing Factors for CRSwNP: Microbiome Disturbance .......................................... 464 X.C.10. Contributing Factors for CRSwNP: Anatomic Variation ................................................ 464 X.C.11. Contributing Factors for CRSwNP: Septal Deviation ..................................................... 464 X.C.12. Contributing Factors for CRSwNP: Innate Immunity .................................................... 468 X.C.13. Contributing Factors for CRSwNP: Epithelial Barrier Disturbance .................................. 481 X.C.14. Contributing Factors for CRSwNP: Ciliary Derangements ............................................. 481 X.C.15. Contributing Factors for CRSwNP: Immunodeficiency .................................................. 481 X.C.16. Contributing Factors for CRSwNP: Genetics and Epigenetics ......................................... 483 X.C.17. Contributing Factors for CRSwNP: Aspirin (Aspirin Exacerbated Respiratory Disease) ..... 483 X.C.18. Contributing Factors for CRSwNP: Viruses ................................................................. 486 X.C.19. Contributing Factors for CRSwNP: Occupational and Environmental Factors .................. 486 X.D. Chronic Rhinosinusitis with Nasal Polyps: Management ............................................................ 486 X.D.1. Management of CRSwNP: Saline (Spray and Irrigation) ................................................. 486 X.D.2. Management of CRSwNP: Topical Corticosteroids ........................................................ 000 X.D.2.a. Topical Corticosteroids: Standard Delivery (Drops and Sprays) ........................... 490 X.D.2.b. Topical Corticosteroids: Nonstandard Delivery ................................................. 492 X.D.2.b.i. Corticosteroid Irrigations ................................................................... 492 X.D.2.b.ii. Exhalation delivery systems .............................................................. 493 X.D.2.b.iii. Nebulizer/Atomization/Injection ...................................................... 493 X.D.2.b.iv. Safety and Systemic Absorption ......................................................... 493 X.D.3. Management of CRSwNP: Steroid-Eluting Implants (Nonsurgical) .................................. 494 X.D.4. Management of CRSwNP: Oral Corticosteroids ............................................................. 494 X.D.5. Management of CRSwNP with Antibiotics ................................................................... 499 X.D.5.a. Antibiotics for CRSwNP: Oral Non-Macrolide Antibiotics for < 3 Weeks ............... 499 X.D.5.b. Antibiotics for CRSwNP: Oral Non-Macrolide Antibiotics for ≥ 3 Weeks ............... 503 X.D.5.c. Antibiotics for CRSwNP: Macrolide Antibiotics ................................................ 504 X.D.5.d. Antibiotics for CRSwNP: Intravenous Antibiotics ............................................. 508 X.D.5.e. Antibiotics for CRSwNP: Topical Antibiotics .................................................... 508 X.D.6. Management of CRSwNP: Antifungals ......................................................................... 508 X.D.7. Management of CRSwNP: Biologic Therapy ................................................................. 508 X.D.8. Management of CRSwNP: Anti-Leukotriene Therapy .................................................... 510 X.D.9. Management of CRSwNP: Probiotics ............................................................................ 513 X.D.10. Management of CRSwNP: Decongestants .................................................................... 513 X.D.11. Management of CRSwNP: Mucolytics ......................................................................... 513 X.D.12. Management of CRSwNP: Herbal Medication .............................................................. 513 X.D.13. Management of CRSwNP: Topical Alternative Therapies ............................................... 515