Publication: European Position Paper on Rhinosinusitis and Nasal Polyps 2020
6
Issued Date
2020-02-20
Resource Type
ISSN
03000729
Other identifier(s)
2-s2.0-85079830392
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Rhinology. Vol.58, (2020), 1-464
Suggested Citation
W. J. Fokkens, V. J. Lund, C. Hopkins, P. W. Hellings, R. Kern, S. Reitsma, S. Toppila-Salmi, M. Bernal-Sprekelsen, J. Mullol, I. Alobid, W. Terezinha Anselmo-Lima, C. Bachert, F. Baroody, C. von Buchwald, A. Cervin, N. Cohen, J. Constantinidis, L. De Gabory, M. Desrosiers, Z. Diamant, R. G. Douglas, P. H. Gevaert, A. Hafner, R. J. Harvey, G. F. Joos, L. Kalogjera, A. Knill, J. H. Kocks, B. N. Landis, J. Limpens, S. Lebeer, O. Lourenco, C. Meco, P. M. Matricardi, L. O'Mahony, C. M. Philpott, D. Ryan, R. Schlosser, B. Senior, T. L. Smith, T. Teeling, P. V. Tomazic, D. Y. Wang, D. Wang, L. Zhang, A. M. Agius, C. Ahlstrom-Emanuelsson, R. Alabri, S. Albu, S. Alhabash, A. Aleksic, M. Aloulah, M. Al-Qudah, S. Alsaleh, M. A. Baban, T. Baudoin, T. Balvers, P. Battaglia, J. D. Bedoya, A. Beule, K. M. Bofares, I. Braverman, E. Brozek-Madry, B. Richard, C. Callejas, S. Carrie, L. Caulley, D. Chussi, E. de Corso, A. Coste, U. El Hadi, A. Elfarouk, P. H. Eloy, S. Farrokhi, G. Felisati, M. D. Ferrari, R. Fishchuk, W. Grayson, P. M. Goncalves, B. Grdinic, V. Grgic, A. W. Hamizan, J. V. Heinichen, S. Husain, T. I. Ping, J. Ivaska, F. Jakimovska, L. Jovancevic, E. Kakande, R. Kamel, S. Karpischenko, H. H. Kariyawasam, H. Kawauchi, A. Kjeldsen, L. Klimek, A. Krzeski, G. Kopacheva Barsova, S. W. Kim, D. Lal, J. J. Letort European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. Vol.58, (2020), 1-464. doi:10.4193/Rhin20.600 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/58205
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Authors
Journal Issue
Thesis
Title
European Position Paper on Rhinosinusitis and Nasal Polyps 2020
Author(s)
W. J. Fokkens
V. J. Lund
C. Hopkins
P. W. Hellings
R. Kern
S. Reitsma
S. Toppila-Salmi
M. Bernal-Sprekelsen
J. Mullol
I. Alobid
W. Terezinha Anselmo-Lima
C. Bachert
F. Baroody
C. von Buchwald
A. Cervin
N. Cohen
J. Constantinidis
L. De Gabory
M. Desrosiers
Z. Diamant
R. G. Douglas
P. H. Gevaert
A. Hafner
R. J. Harvey
G. F. Joos
L. Kalogjera
A. Knill
J. H. Kocks
B. N. Landis
J. Limpens
S. Lebeer
O. Lourenco
C. Meco
P. M. Matricardi
L. O'Mahony
C. M. Philpott
D. Ryan
R. Schlosser
B. Senior
T. L. Smith
T. Teeling
P. V. Tomazic
D. Y. Wang
D. Wang
L. Zhang
A. M. Agius
C. Ahlstrom-Emanuelsson
R. Alabri
S. Albu
S. Alhabash
A. Aleksic
M. Aloulah
M. Al-Qudah
S. Alsaleh
M. A. Baban
T. Baudoin
T. Balvers
P. Battaglia
J. D. Bedoya
A. Beule
K. M. Bofares
I. Braverman
E. Brozek-Madry
B. Richard
C. Callejas
S. Carrie
L. Caulley
D. Chussi
E. de Corso
A. Coste
U. El Hadi
A. Elfarouk
P. H. Eloy
S. Farrokhi
G. Felisati
M. D. Ferrari
R. Fishchuk
W. Grayson
P. M. Goncalves
B. Grdinic
V. Grgic
A. W. Hamizan
J. V. Heinichen
S. Husain
T. I. Ping
J. Ivaska
F. Jakimovska
L. Jovancevic
E. Kakande
R. Kamel
S. Karpischenko
H. H. Kariyawasam
H. Kawauchi
A. Kjeldsen
L. Klimek
A. Krzeski
G. Kopacheva Barsova
S. W. Kim
D. Lal
J. J. Letort
V. J. Lund
C. Hopkins
P. W. Hellings
R. Kern
S. Reitsma
S. Toppila-Salmi
M. Bernal-Sprekelsen
J. Mullol
I. Alobid
W. Terezinha Anselmo-Lima
C. Bachert
F. Baroody
C. von Buchwald
A. Cervin
N. Cohen
J. Constantinidis
L. De Gabory
M. Desrosiers
Z. Diamant
R. G. Douglas
P. H. Gevaert
A. Hafner
R. J. Harvey
G. F. Joos
L. Kalogjera
A. Knill
J. H. Kocks
B. N. Landis
J. Limpens
S. Lebeer
O. Lourenco
C. Meco
P. M. Matricardi
L. O'Mahony
C. M. Philpott
D. Ryan
R. Schlosser
B. Senior
T. L. Smith
T. Teeling
P. V. Tomazic
D. Y. Wang
D. Wang
L. Zhang
A. M. Agius
C. Ahlstrom-Emanuelsson
R. Alabri
S. Albu
S. Alhabash
A. Aleksic
M. Aloulah
M. Al-Qudah
S. Alsaleh
M. A. Baban
T. Baudoin
T. Balvers
P. Battaglia
J. D. Bedoya
A. Beule
K. M. Bofares
I. Braverman
E. Brozek-Madry
B. Richard
C. Callejas
S. Carrie
L. Caulley
D. Chussi
E. de Corso
A. Coste
U. El Hadi
A. Elfarouk
P. H. Eloy
S. Farrokhi
G. Felisati
M. D. Ferrari
R. Fishchuk
W. Grayson
P. M. Goncalves
B. Grdinic
V. Grgic
A. W. Hamizan
J. V. Heinichen
S. Husain
T. I. Ping
J. Ivaska
F. Jakimovska
L. Jovancevic
E. Kakande
R. Kamel
S. Karpischenko
H. H. Kariyawasam
H. Kawauchi
A. Kjeldsen
L. Klimek
A. Krzeski
G. Kopacheva Barsova
S. W. Kim
D. Lal
J. J. Letort
Other Contributor(s)
Klinički Bolnički Centar Sestre Milosrdnice
CHU UCL Namur
University of East Anglia, Norwich Medical School
Edinburgh Medical School
Hospital de Clínicas
University of Banja Luka
Sveučilište u Zagrebu, Farmaceutsko Biokemijski Fakultet
Skin and Allergy Hospital
University of Sulaimaniya
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore
Beijing Tongren Hospital, Capital Medical University
L-Università ta' Malta
SS Cyril and Methodius University
Omar Al-Mukhtar University
Sultan Qaboos University
Makerere University
Kilimanjaro Christian Medical College
Medical University of Warsaw
University of Novi Sad
American University of Beirut
University Hospital of Ghent
Vilniaus universitetas
Universidad de Antioquia
Jordan University of Science and Technology
Universiteit Gent
KU Leuven– University Hospital Leuven
The University of Queensland
Københavns Universitet
Università degli Studi di Milano
Royal National Throat, Nose and Ear Hospital
Pontificia Universidad Católica de Chile
Lunds Universitet
University of Ottawa, Canada
Royal Brisbane and Women's Hospital
Stockholms universitet
Hille Yaffe Medical Center Israel
The University of Alabama at Birmingham
Mayo Clinic Scottsdale-Phoenix, Arizona
Yong Loo Lin School of Medicine
Shimane University
Charité – Universitätsmedizin Berlin
University College Cork
Université Paris-Est Créteil
Universiti Malaysia Sarawak
Medical University of South Carolina
University of Chicago Medicine Comer Children's Hospital
UNC School of Medicine
Macquarie University
Syddansk Universitet
Oregon Health & Science University
Charles University
Leiden University Medical Center - LUMC
Bushehr University of Medical Sciences
Aristotle University of Thessaloniki
Paracelsus Medizinische Privatuniversitat
Skånes universitetssjukhus
Northwestern University Feinberg School of Medicine
King Saud University
Universitatea de Medicina si Farmacie Iuliu Hatieganu din Cluj-Napoca
Universiteit Antwerpen
Ankara Üniversitesi
Cairo University
Hôpitaux universitaires de Genève
Fudan University
University of Montreal
Universidade de Sao Paulo - USP
Universitätsklinikum Münster
University of Zagreb School of Medicine
Medizinische Universität Graz
Newcastle University, United Kingdom
University of Auckland
Guy's and St Thomas' NHS Foundation Trust
Università degli Studi dell'Insubria
University of Pennsylvania Perelman School of Medicine
Groupe Hospitalier Pellegrin
Pavlov University
University of Valencia
Universiteit van Amsterdam
Kyung Hee University
Universiti Kebangsaan Malaysia
Universitat de Barcelona
James Paget University Hospitals NHS Foundation Trust
Universidade da Beira Interior
Director of Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
ENT Department
Persian Gulf Tropical Medicine Research Center
University If Medicine
Research Director Respiratory and Allergy
Central city clinical hospital of lvano-Frankivsk city council
Pontifical University Catholic of Ecuador
Centro Hospitalar de Entre Douro e Vouga
Patient representative
Zagreb University School of Medicine
Observational and Pragmatic Research Institute
Patient Representative
Center for Rhinology and Allergology
Optimum Patient Care
Mulago National Referral Hospital
General Hospital
Roy. Nat. ENT Hosp.
CHU UCL Namur
University of East Anglia, Norwich Medical School
Edinburgh Medical School
Hospital de Clínicas
University of Banja Luka
Sveučilište u Zagrebu, Farmaceutsko Biokemijski Fakultet
Skin and Allergy Hospital
University of Sulaimaniya
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore
Beijing Tongren Hospital, Capital Medical University
L-Università ta' Malta
SS Cyril and Methodius University
Omar Al-Mukhtar University
Sultan Qaboos University
Makerere University
Kilimanjaro Christian Medical College
Medical University of Warsaw
University of Novi Sad
American University of Beirut
University Hospital of Ghent
Vilniaus universitetas
Universidad de Antioquia
Jordan University of Science and Technology
Universiteit Gent
KU Leuven– University Hospital Leuven
The University of Queensland
Københavns Universitet
Università degli Studi di Milano
Royal National Throat, Nose and Ear Hospital
Pontificia Universidad Católica de Chile
Lunds Universitet
University of Ottawa, Canada
Royal Brisbane and Women's Hospital
Stockholms universitet
Hille Yaffe Medical Center Israel
The University of Alabama at Birmingham
Mayo Clinic Scottsdale-Phoenix, Arizona
Yong Loo Lin School of Medicine
Shimane University
Charité – Universitätsmedizin Berlin
University College Cork
Université Paris-Est Créteil
Universiti Malaysia Sarawak
Medical University of South Carolina
University of Chicago Medicine Comer Children's Hospital
UNC School of Medicine
Macquarie University
Syddansk Universitet
Oregon Health & Science University
Charles University
Leiden University Medical Center - LUMC
Bushehr University of Medical Sciences
Aristotle University of Thessaloniki
Paracelsus Medizinische Privatuniversitat
Skånes universitetssjukhus
Northwestern University Feinberg School of Medicine
King Saud University
Universitatea de Medicina si Farmacie Iuliu Hatieganu din Cluj-Napoca
Universiteit Antwerpen
Ankara Üniversitesi
Cairo University
Hôpitaux universitaires de Genève
Fudan University
University of Montreal
Universidade de Sao Paulo - USP
Universitätsklinikum Münster
University of Zagreb School of Medicine
Medizinische Universität Graz
Newcastle University, United Kingdom
University of Auckland
Guy's and St Thomas' NHS Foundation Trust
Università degli Studi dell'Insubria
University of Pennsylvania Perelman School of Medicine
Groupe Hospitalier Pellegrin
Pavlov University
University of Valencia
Universiteit van Amsterdam
Kyung Hee University
Universiti Kebangsaan Malaysia
Universitat de Barcelona
James Paget University Hospitals NHS Foundation Trust
Universidade da Beira Interior
Director of Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
ENT Department
Persian Gulf Tropical Medicine Research Center
University If Medicine
Research Director Respiratory and Allergy
Central city clinical hospital of lvano-Frankivsk city council
Pontifical University Catholic of Ecuador
Centro Hospitalar de Entre Douro e Vouga
Patient representative
Zagreb University School of Medicine
Observational and Pragmatic Research Institute
Patient Representative
Center for Rhinology and Allergology
Optimum Patient Care
Mulago National Referral Hospital
General Hospital
Roy. Nat. ENT Hosp.
Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.