ICON: chronic rhinosinusitis.
Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. Moreover, the complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference. In this document we discuss the definition of the disease, its relevance, pharmacoeconomics, pathophysiology, phenotypes and endotypes, genetics and risk factors, natural history and co-morbidities as well as clinical manifestations and treatment options in both adults and children comprising pharmacotherapy, surgical interventions and more recent biological approaches. Finally, we have also highlighted the unmet needs that wait to be addressed through future research.
Upper Airways Research Laboratory (URL), University Hospital Ghent, Kragujevac, Belgium.
Claus
C
Bachert
Div. of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan.
Ruby
R
Pawankar
Beijing Key Laboratory of Nasal diseases, Beijing Institute of Otolaryngology, Beijing, China.
Luo
L
Zhang
Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand.
Chaweewan
C
Bunnag
Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
Wytske J
WJ
Fokkens
Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, MA USA.
Daniel L
DL
Hamilos
Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand.
Orathai
O
Jirapongsananuruk
Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA.
Robert
R
Kern
Allergy & Asthma Medical Group & Research Center, San Diego, California USA.
Eli O
EO
Meltzer
Rhinology Unit & Smell Clinic, Hospital Clínic - IDIBAPS, Barcelona, Catalonia Spain.
Joaquim
J
Mullol
Section of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, Illinois USA.
Robert
R
Naclerio
Department of Otorhinolaryngology, Clinics Hospital/University of Sao Paulo Medical School, Kragujevac, Brazil.
Renata
R
Pilan
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Seoul, Korea.
Chae-Seo
CS
Rhee
Dept. of Otorhinolaryngology, Showa University, Tokyo, Japan.
Harumi
H
Suzaki
Department of Rhinology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Richard
R
Voegels
University of Tennessee Health Science Center, Memphis, Tennessee.
Michael
M
Blaiss
Biologicals; Chronic rhinosinusitis; Co-morbidities; Genetics; Pathophysiology; Pharmacoeconomics; Phenotypes; Treatment; Unmet needs