title: A survey on chronic rhinosinusitis: opinions from experts of 50 countries.
abstract: 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.
authors.affiliation: Department for ORL Head and Neck Surgery, University of Siena, Siena, Italy.
authors.forename: Desiderio
authors.initials: D
authors.lastname: Passali
authors.affiliation: Department for ORL Head and Neck Surgery, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Cingi
authors.affiliation: Department for ORL Head and Neck Surgery, University of Siena, Siena, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Cambi
authors.affiliation: ENT Clinics, University of Roma Tor Vergata, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Passali
authors.affiliation: Department for ORL Head and Neck Surgery, Faculty of Medicine, Kırıkkale University, Kirikkale, Turkey. nbayarmuluk@yahoo.com.|, Birlik Mahallesi, Zirvekent 2. Etap Sitesi, C-3 Blok, No: 6-3/43, 06610, Çankaya/Ankara, Turkey. nbayarmuluk@yahoo.com.
authors.forename: Nuray Bayar
authors.initials: NB
authors.lastname: Muluk
authors.affiliation: Department for ORL Head and Neck Surgery, University of Siena, Siena, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Bellussi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004724:Endoscopy; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000627:therapeutic use; D009297:Nasal Mucosa; D015508:Nasal Obstruction / Q000150:complications; D009298:Nasal Polyps / Q000150:complications; D011182:Postoperative Care; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D007507:Therapeutic Irrigation
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D014663:Nasal Decongestants
keywords: Chronic rhinosinusitis (CRS); Chronic rhinosinusitis with nasal polyps (CRSwNP); Chronic rhinosinusitis without nasal polyps (CRSsNP); Countries; Otorhinolaryngologist; Treatment