Department of Otolaryngology - Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Curr Opin Otolaryngol Head Neck Surg. 2023 Feb 1;31(1):17-23. doi: 10.1097/MOO.0000000000000858. Epub 2022 Nov 15.
Control is a global disease metric defined as the extent to which manifestations of a disease are within acceptable limits. Control serves as the goal of treatment for chronic diseases, such as chronic rhinosinusitis (CRS), that cannot be cured. The objective of this review is to summarize recommendations for assessment of CRS control with a specific focus on how these recommendations align with patients' and healthcare providers' perspectives of CRS control.
Several staging systems for CRS control have been developed with the first and most widely recognized by the 2012 European Position Paper on Rhinosinusitis and Nasal Polyps, which was developed through expert opinion. Patients' and providers'/guideline-based assessments of CRS control frequently do not align. Patients understand the concept of CRS control and their assessment is dominated by the perceived severity of nasal symptoms. In comparison, providers' and guideline-based assessments of control are more global, incorporating nasal and extra-nasal symptoms, need for systemic antibiotics and corticosteroids, and nasal endoscopy.
Although more research is needed, future development of CRS control criteria through consensus around explicitly determined perspectives of healthcare providers and patients may one day serve as the foundation for a standardized approach to treatment of CRS.
控制是一种全球疾病衡量标准，定义为疾病表现处于可接受范围内的程度。控制是无法治愈的慢性疾病（如慢性鼻-鼻窦炎，CRS）治疗的目标。本综述的目的是总结 CRS 控制评估的建议，特别关注这些建议如何与患者和医疗保健提供者对 CRS 控制的看法相一致。
已经开发了几种 CRS 控制的分期系统，其中第一个也是最广泛认可的是 2012 年欧洲鼻-鼻窦炎和鼻息肉意见书，该系统是通过专家意见制定的。患者和提供者/基于指南的 CRS 控制评估经常不一致。患者理解 CRS 控制的概念，他们的评估主要由鼻腔症状的严重程度决定。相比之下，提供者和基于指南的控制评估更加全面，包括鼻腔和鼻腔外症状、对全身抗生素和皮质类固醇的需求以及鼻内窥镜检查。
尽管需要更多的研究，但通过围绕医疗保健提供者和患者明确确定的观点达成共识，未来可能会制定出 CRS 控制标准，为 CRS 治疗的标准化方法奠定基础。
