Deuss Eric, Becker Sven, Meyer Moritz, Hussain Timon, Eckrich Jonas, Lang Stephan, Klimek Ludger, Ernst Benjamin
Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Essen, Germany.
Universitätsklinik für Hals-Nasen-Ohren-Heilkunde Universitätsklinikum Tübingen, Tübingen, Germany.
Laryngorhinootologie. 2024 Sep;103(9):646-654. doi: 10.1055/a-2246-2793. Epub 2024 Apr 2.
With a prevalence of 0.55% to 4%, chronic rhinosinusitis with nasal polyps (CRSwNP) is a relevant part of the daily work of German otolaryngologists. The aim of the questionnaire-based data collection was to assess the current treatment status of CRSwNP in Germany.
For this purpose, 24 questions within an anonymized online questionnaire were sent to all German ENT departments.
Of 160 contacted ENT departments, 50 participated in the survey (31.3%). Among these, 76% performed more than 100 sinus surgeries annually and 38% treated more than 50 patients with biologics. Saline irrigations (80%) and intranasal glucocorticoids (GCS, 96%) were the most common conservative therapies. Systemic GCSs (52%) and intranasal GCS irrigation (20%) were less common. 80% of departments used biologics in the therapy of CRSwNP with an overall preference for dupilumab (70%). For therapy of aspirin intolerance, biologics (52%) were preferred to aspirin desensitization (26%). Prior to treatment with biologics clinical workup included the nasal polyp score (90%), the SNOT-22 questionnaire (84%), surrogate markers of type 2 inflammation (60%-72%), and computer tomography (50%). Final treatment success was assessed after 24 weeks (50%).
Mostly, the responding departments followed German and European recommendations for diagnosis and therapy of CRSwNP. Therapy with biologics is widely used. The value of preoperative systemic GCS and the frequent performance of CT before initiation of therapy with a biologic should be debated in regard to its currently widespread use.
慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的患病率为0.55%至4%，是德国耳鼻喉科医生日常工作中的一个重要部分。基于问卷调查的数据收集旨在评估德国CRSwNP的当前治疗状况。
为此，一份包含24个问题的匿名在线问卷被发送给了德国所有的耳鼻喉科科室。
在联系的160个耳鼻喉科科室中，50个科室参与了调查（31.3%）。其中，76%的科室每年进行超过100例鼻窦手术，38%的科室治疗超过50例使用生物制剂的患者。盐水冲洗（80%）和鼻内糖皮质激素（GCS，96%）是最常见的保守治疗方法。全身用GCS（52%）和鼻内GCS冲洗（20%）较少见。80%的科室在CRSwNP治疗中使用生物制剂，总体上更倾向于度普利尤单抗（70%）。对于阿司匹林不耐受的治疗，生物制剂（52%）比阿司匹林脱敏（26%）更受青睐。在使用生物制剂治疗前，临床检查包括鼻息肉评分（90%）、SNOT-22问卷（84%）、2型炎症的替代标志物（60%-72%）和计算机断层扫描（50%）。24周后评估最终治疗效果（50%）。
大多数回复的科室遵循德国和欧洲关于CRSwNP诊断和治疗的建议。生物制剂治疗被广泛使用。术前全身用GCS的价值以及在开始生物制剂治疗前频繁进行CT检查的做法，鉴于其目前的广泛应用，值得探讨。
