Passali Desiderio, Cingi Cemal, Cambi Jacopo, Passali Francesco, Muluk Nuray Bayar, Bellussi Maria Luisa
Department for ORL Head and Neck Surgery, University of Siena, Siena, Italy.
Department for ORL Head and Neck Surgery, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.
Eur Arch Otorhinolaryngol. 2016 Aug;273(8):2097-109. doi: 10.1007/s00405-015-3880-6. Epub 2016 Jan 7.
Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Society of Rhinology. In 79.1 % of the 50 countries, the proportion of patients suffering from CRS was 15 %. Nasal symptoms were more intense in winter (46 % of countries), and spring and autumn (22 %). The most common symptoms were nasal obstruction (86 %), postnasal drip (82 %) and headache (52 %). The most common investigative modalities in the assessment of CRS are paranasal sinus CT, fiberoptic endoscopy, and anterior rhinoscopy. CRS patients were principally treated by otorhinolaryngologists (70 %). Medical treatments included nasal corticosteroids (90 %), nasal washes (68 %), and nasal decongestants (32 %). In 88 % of countries, more than 50 %, or "about 50 %", of all patients reported subjective symptom improvement after treatment. In most of the countries, surgery was required by 20-35 % of all CRS patients. During post-surgery follow-up, nasal washes (90 %), nasal corticosteroids (76 %), and systemic antibiotics (32 %) were prescribed. In 20-40 % of all patients, CRS was associated with nasal polyps. In such patients, the medical treatment options were nasal corticosteroids (90 %), systemic corticosteroids (50 %), nasal washes (46 %), and systemic antibiotics (34 %). Treatment of CRS patients varies in different countries. Paranasal sinus CT is the most common investigative modality in the assessment of CRS, and nasal corticosteroids are the first-line treatment, in the absence or presence of nasal polyps.
慢性鼻-鼻窦炎（CRS）是一种非常常见的炎症性疾病。不同国家的治疗方法各不相同。在本研究中，我们探究了50个国家医生的治疗方法。在这项横断面研究中，意大利鼻科学会的名誉会员和通讯会员（耳鼻喉科医生）完成了一项鼻-鼻窦炎调查（RSS）。在50个国家中，79.1%的国家CRS患者比例为15%。冬季（46%的国家）以及春季和秋季（22%）时鼻部症状更为严重。最常见的症状是鼻塞（86%）、鼻后滴漏（82%）和头痛（52%）。评估CRS时最常用的检查方式是鼻窦CT、纤维鼻咽喉镜检查和前鼻镜检查。CRS患者主要由耳鼻喉科医生治疗（70%）。药物治疗包括鼻用糖皮质激素（90%）、鼻腔冲洗（68%）和鼻减充血剂（32%）。在88%的国家，超过50%或“约50%”的所有患者报告治疗后主观症状有所改善。在大多数国家，20% - 35%的所有CRS患者需要进行手术。在术后随访期间，会开具鼻腔冲洗（90%）、鼻用糖皮质激素（76%）和全身性抗生素（32%）。在所有患者中，20% - 40%的CRS与鼻息肉有关。在这类患者中，药物治疗选择包括鼻用糖皮质激素（90%）、全身性糖皮质激素（50%）、鼻腔冲洗（46%）和全身性抗生素（34%）。不同国家对CRS患者的治疗方法各不相同。鼻窦CT是评估CRS时最常用的检查方式，无论有无鼻息肉，鼻用糖皮质激素都是一线治疗药物。
