Giunta Gianmarco, Pirola Francesca, Giombi Francesco, Muci Giovanna, Pace Gian Marco, Heffler Enrico, Paoletti Giovanni, Puggioni Francesca, Cerasuolo Michele, Ferreli Fabio, Salamanca Fabrizio, Mercante Giuseppe, Spriano Giuseppe, Canonica Giorgio Walter, Malvezzi Luca
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy.
Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
J Pers Med. 2023 Mar 31;13(4):618. doi: 10.3390/jpm13040618.
In the last 20 years, growing interest in chronic rhinosinusitis (CRS) has become evident in medical literature; nevertheless, it is still difficult to identify the real prevalence of the disease. Epidemiological studies are few and focused on heterogeneous populations and diagnostic methods. Recent research has contributed to identifying CRS as a disease characterized by heterogeneous clinical scenarios, high impact on quality of life, and elevated social costs. Patient stratification with phenotypes and identification of the pathobiological mechanism at the origin of the disease (endotype) and its comorbidities are pivotal in the diagnostic process, and they should be addressed in order to properly tailor treatment. A multidisciplinary approach, shared diagnostic and therapeutic data, and follow-up processes are therefore necessary. Oncological multidisciplinary boards offer models to imitate in accordance with the principles of precision medicine: tracing a diagnostic pathway with the purpose of identifying the patient's immunological profile, monitoring therapeutical processes, abstaining from having only a single specialist involved in treatment, and placing the patient at the center of the therapeutic plan. Awareness and participation from the patient's perspective are fundamental steps to optimize the clinical course, improve quality of life, and reduce the socioeconomic burden.
在过去20年里，医学文献中对慢性鼻-鼻窦炎（CRS）的兴趣日益浓厚；然而，仍难以确定该疾病的实际患病率。流行病学研究较少，且集中在异质性人群和诊断方法上。近期研究有助于将CRS确定为一种具有异质性临床情况、对生活质量影响大且社会成本高的疾病。根据表型对患者进行分层，并确定疾病起源的病理生物学机制（内型）及其合并症，在诊断过程中至关重要，为了合理调整治疗方案应予以关注。因此，多学科方法、共享诊断和治疗数据以及随访流程是必要的。肿瘤多学科委员会提供了可依据精准医学原则效仿的模式：探寻诊断途径以确定患者的免疫特征，监测治疗过程，避免仅由单一专科医生参与治疗，并将患者置于治疗计划的中心。从患者角度提高认识和参与度是优化临床病程、改善生活质量以及减轻社会经济负担的基本步骤。
