xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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TABLE IX-1 Evidence for establishing the diagnosis of CRS Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Kim 529 2019 1 Meta-analysis (16 retrospective studies) Studies involving diagnostic evaluation of CRS, comparing endoscopy and CT with sensitivity and specificity analysis and correlation Evaluate accuracy of nasal endoscopy vs CT in diagnosing CRS Endoscopic and CT findings were significantly associated (r = 0.8543).

The diagnostic accuracy of endoscopy correlated with Lund-Kennedy score ≥ 2.

Orlandi 1 2016 1 Systematic Review AdultRS Diagnosis based on 12 or more weeks of cardinal symptoms; objective evidence required for diagnosis. Rosenfeld 88 2015 1 Systematic Review (5 guidelines, 42 systematic reviews, 70RCTs)

Strong recommendation for the diagnostic criteria.

Diagnosis of CRS entails at least 2 CPODS present for 8-12 weeks plus documented objective finding (CT or endoscopy) of inflammation.

CRS CRS diagnosed based on type and duration of symptoms plus objective findings of nasal inflammation. Meltzer 479 2011 1 Review of Consensus Statements

Adults with RS The diagnosis of CRS should include the presence of sinonasal inflammation as seen on anterior rhinoscopy, nasal endoscopy or CT. Kaplan 142 2014 1 Clinical Practice Guidelines (Canada)

RS and subtypes Require presence of 2/4 symptoms (nasal congestion, anterior/posterior mucopurulent drainage, facial pain/pressure, decreased smell).

Diagnostic testing is key difference between CRS and ARS.

Adult CRS pts Develop CRS-specific quality indicators to evaluate

diagnosis and management

Cottrell 522 2018 2 Literature review (3 guidelines, 1 consensus

statement)