Manon Blauwblomme, Christos Georgalas, Shahzada Ahmed, Isam Alobid, Paolo Battaglia, Paolo Castelnuovo, Jannis Constantinidis, Iacopo Dallan, Anne-Sophie Eeckels, Marco Ferrari, Philippe Gevaert, Jessica Grayson, Richard Harvey, Philippe Herman, Iordanis Konstantinidis, Darlene Lubbe, Cem Meco, James Palmer, Zara M. Patel, Agnieszka Strzembosz, Benjamin Verillaud, Bradford A. Woodworth, Thibaut Van Zele
{"title":"原发性弥漫型2型优势型慢性鼻窦炎手术治疗的专家共识。","authors":"Manon Blauwblomme, Christos Georgalas, Shahzada Ahmed, Isam Alobid, Paolo Battaglia, Paolo Castelnuovo, Jannis Constantinidis, Iacopo Dallan, Anne-Sophie Eeckels, Marco Ferrari, Philippe Gevaert, Jessica Grayson, Richard Harvey, Philippe Herman, Iordanis Konstantinidis, Darlene Lubbe, Cem Meco, James Palmer, Zara M. Patel, Agnieszka Strzembosz, Benjamin Verillaud, Bradford A. Woodworth, Thibaut Van Zele","doi":"10.1002/alr.23538","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Chronic rhinosinusitis (CRS) poses significant challenges in surgical management due to the lack of clear guidelines, particularly in type 2 CRS. This review focuses on surgical approaches for primary diffuse type 2-dominant CRS, emphasizing preoperative and intraoperative strategies.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A consensus group, comprising experts from Europe, United Kingdom, Australia, South Africa, North and South America, was assembled. Using a modified Delphi method, 67 statements were formulated following a literature review, with an additional statement added in the second iteration. Final recommendations were discussed during a consensus meeting in Santorini, Greece, in October 2023.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Out of the 68 proposed statements, consensus was achieved on 45. Most (34) statements received a median score of 7 (strongly agree), and 11 had a median score of 6 (agree). The finalized recommendations cover the indications, timing, extent of surgery, and intraoperative management for both primary and revision surgery in primary diffuse type 2-dominant CRS. A key focus is on complete sinus surgery, which involves creating a neo-sinus cavity by removing bone partitions in the ethmoid and opening the frontal and sphenoidal sinuses as needed. Adequate primary and revision surgery includes clearing all nasal polyps and diseased mucosa while ensuring ideal conditions for topical therapy. Additionally, there was consensus on performing complete sinus surgery before considering monoclonal antibody therapies, unless contraindicated.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>These 45 consensus statements, derived from both current evidence and expert opinion, provide valuable guidance for clinicians in the surgical management of primary diffuse type 2-dominant CRS.</p>\n </section>\n </div>","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"15 3","pages":"303-316"},"PeriodicalIF":7.2000,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23538","citationCount":"0","resultStr":"{\"title\":\"Expert Consensus on Surgical Management of Primary Diffuse Type 2-Dominant Chronic Rhinosinusitis\",\"authors\":\"Manon Blauwblomme, Christos Georgalas, Shahzada Ahmed, Isam Alobid, Paolo Battaglia, Paolo Castelnuovo, Jannis Constantinidis, Iacopo Dallan, Anne-Sophie Eeckels, Marco Ferrari, Philippe Gevaert, Jessica Grayson, Richard Harvey, Philippe Herman, Iordanis Konstantinidis, Darlene Lubbe, Cem Meco, James Palmer, Zara M. Patel, Agnieszka Strzembosz, Benjamin Verillaud, Bradford A. Woodworth, Thibaut Van Zele\",\"doi\":\"10.1002/alr.23538\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Chronic rhinosinusitis (CRS) poses significant challenges in surgical management due to the lack of clear guidelines, particularly in type 2 CRS. This review focuses on surgical approaches for primary diffuse type 2-dominant CRS, emphasizing preoperative and intraoperative strategies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A consensus group, comprising experts from Europe, United Kingdom, Australia, South Africa, North and South America, was assembled. Using a modified Delphi method, 67 statements were formulated following a literature review, with an additional statement added in the second iteration. Final recommendations were discussed during a consensus meeting in Santorini, Greece, in October 2023.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Out of the 68 proposed statements, consensus was achieved on 45. Most (34) statements received a median score of 7 (strongly agree), and 11 had a median score of 6 (agree). The finalized recommendations cover the indications, timing, extent of surgery, and intraoperative management for both primary and revision surgery in primary diffuse type 2-dominant CRS. A key focus is on complete sinus surgery, which involves creating a neo-sinus cavity by removing bone partitions in the ethmoid and opening the frontal and sphenoidal sinuses as needed. Adequate primary and revision surgery includes clearing all nasal polyps and diseased mucosa while ensuring ideal conditions for topical therapy. Additionally, there was consensus on performing complete sinus surgery before considering monoclonal antibody therapies, unless contraindicated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>These 45 consensus statements, derived from both current evidence and expert opinion, provide valuable guidance for clinicians in the surgical management of primary diffuse type 2-dominant CRS.</p>\\n </section>\\n </div>\",\"PeriodicalId\":13716,\"journal\":{\"name\":\"International Forum of Allergy & Rhinology\",\"volume\":\"15 3\",\"pages\":\"303-316\"},\"PeriodicalIF\":7.2000,\"publicationDate\":\"2025-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/alr.23538\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Forum of Allergy & Rhinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/alr.23538\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Forum of Allergy & Rhinology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/alr.23538","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Expert Consensus on Surgical Management of Primary Diffuse Type 2-Dominant Chronic Rhinosinusitis
Background
Chronic rhinosinusitis (CRS) poses significant challenges in surgical management due to the lack of clear guidelines, particularly in type 2 CRS. This review focuses on surgical approaches for primary diffuse type 2-dominant CRS, emphasizing preoperative and intraoperative strategies.
Methods
A consensus group, comprising experts from Europe, United Kingdom, Australia, South Africa, North and South America, was assembled. Using a modified Delphi method, 67 statements were formulated following a literature review, with an additional statement added in the second iteration. Final recommendations were discussed during a consensus meeting in Santorini, Greece, in October 2023.
Results
Out of the 68 proposed statements, consensus was achieved on 45. Most (34) statements received a median score of 7 (strongly agree), and 11 had a median score of 6 (agree). The finalized recommendations cover the indications, timing, extent of surgery, and intraoperative management for both primary and revision surgery in primary diffuse type 2-dominant CRS. A key focus is on complete sinus surgery, which involves creating a neo-sinus cavity by removing bone partitions in the ethmoid and opening the frontal and sphenoidal sinuses as needed. Adequate primary and revision surgery includes clearing all nasal polyps and diseased mucosa while ensuring ideal conditions for topical therapy. Additionally, there was consensus on performing complete sinus surgery before considering monoclonal antibody therapies, unless contraindicated.
Conclusion
These 45 consensus statements, derived from both current evidence and expert opinion, provide valuable guidance for clinicians in the surgical management of primary diffuse type 2-dominant CRS.
期刊介绍：
International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy.
International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
