EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists
Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, 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. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the…
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Approximately 2% of viral rhinitis episodes are secondarily infected by bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with subsequent acute bacterial infection.
“Approximately 2% of viral rhinitis episodes are secondarily infected by bacterial organisms such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with subsequent presentation of acute bacterial infection.138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Section 2.2, “Clinical definition of rhinosinusitis in children” (page unavailable), says that a small percentage of patients with post-viral acute rhinosinusitis develop bacterial acute rhinosinusitis. It does not give a 2% rate for viral rhinitis episodes or name the three bacterial species; it also uses post-viral rhinosinusitis patients, rather than all viral rhinitis episodes, as the denominator. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDevelopment of acute, moderate to severe symptoms and nasal purulence may be consistent with ARS or RARS rather than AR.
“The development of acute, moderate to severe symptoms, and nasal purulence may be consistent with ARS or RARS rather than AR.1,137,138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Sections 2.1 and 2.2 include nasal discharge and mucopurulent discharge in the clinical definition of rhinosinusitis, and section 2.2 discusses acute rhinosinusitis. The retrieved passages do not establish that moderate-to-severe symptoms or nasal purulence distinguish ARS or RARS from allergic rhinitis, and they do not address RARS specifically. (LLM, conf=0.83)
Experimental — accuracy not yet measuredNasal discharge in ARS is often purulent and may be discolored, with a tendency to be unilateral although it may be bilateral.
“Nasal discharge is often purulent and may be discolored, with a tendency to be unilateral although may be bilateral.1,138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Sections 2.1 and 2.2 (page not available in our copy) identify nasal discharge as a rhinosinusitis symptom and mucopurulent discharge as a possible endoscopic sign. They do not say that discharge in acute rhinosinusitis is often purulent, may be discolored, or tends to be unilateral rather than bilateral. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSome improvement in NO has been described in patients with nonallergic rhinitis or rhinosinusitis with H1 antihistamines, but the evidence is very weak.
“Some improvement in NO has been described in patients with NAR or rhinosinusitis, but the evidence is very weak”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [130]
The CRS treatment table (p. 5) lists no data for adding oral antihistamines in allergic patients, consistent with the claim that evidence is weak. It does not describe improved nasal obstruction or address antihistamine treatment in nonallergic rhinitis; the treatment table on p. 8 likewise concerns allergic patients. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIntranasal corticosteroids have a potent anti-inflammatory effect and have proven effective in treating NO in both rhinitis and rhinosinusitis.
“Intranasal corticosteroids (INCs) (beclomethasone, budesonide, ciclesonide, fluticasone propionate, fluticasone furoate, mometasone, triamcinolone) have a potent antiinflammatory effect and have proven to be effective in treating NO in both rhinitis and rhinosinusitis, as shown in several international consensus statements [127-131].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [130]
The paediatric CRS introduction (p. 9) states that intranasal corticosteroids have proven efficacy in adult chronic rhinosinusitis and in childhood allergic rhinitis; the CRSwNP management section (p. 7) also reports improved symptoms. The paper identifies nasal obstruction as a rhinosinusitis symptom (clinical definition, p. 3), but the passages do not specifically establish relief of nasal obstruction (NO) in both conditions or describe the drugs’ anti-inflammatory effect as potent. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Endoscopic surgical treatment is beneficial in patients with chronic rhinosinusitis with nasal polyps who have severe symptoms and do not respond to appropriate medical treatment.
“In CRS with NP , endoscopic surgical treatment has been shown to be beneficial in patients with severe symptoms who do not respond to appropriate medical treatment [20,127,128,212-218] and may be more cost-effective [219,220].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [20]
The adult CRS section (p. 4) reports a study including patients with and without nasal polyps in which both endoscopic surgery and erythromycin significantly improved symptoms. The paediatric CRS section (p. 9) says surgery is usually considered after maximal medical therapy fails. Neither passage establishes the claimed benefit specifically for patients with nasal polyps who have severe symptoms and have not responded to appropriate medical treatment. (LLM, conf=0.78)
Experimental — accuracy not yet measuredRhinosinusitis conditions are characterized by nasal obstruction, nasal congestion, facial pressure or pain, anterior or posterior nasal discharge, and anosmia or hyposmia for varying durations.
“Symptomatically, these conditions are characterized by nasal obstruction, nasal congestion, facial pressure or pain, anterior or posterior nasal discharge, and anosmia/hyposmia for varying durations of time.1,138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
International consensus statements recommend intranasal corticosteroids for acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps.
“International consensus statements [127,130] recommend the use of INCs for both ARS and CRS with NP or CRS without NP.”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [130]
AR is typically not associated with purulent or unilateral nasal discharge.
“Conversely, AR is typically not associated with purulent or unilateral nasal discharge.”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
The clinical definitions of rhinosinusitis (sections 2.1–2.2; page unavailable) list mucopurulent discharge as a possible sign of rhinosinusitis, but do not describe the usual discharge in allergic rhinitis. Searches for unilateral discharge and for a comparison with allergic rhinitis found no passage establishing that purulent or unilateral discharge is typically absent in allergic rhinitis. (LLM, conf=0.73)
Experimental — accuracy not yet measuredA longer duration of illness suggests bacterial ARS.
“A longer duration of illness suggests bacterial ARS.137,138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Section 2.2 distinguishes post-viral from bacterial acute rhinosinusitis and says only a small percentage of post-viral cases are bacterial. It does not say whether a longer illness makes bacterial ARS more likely; searches for illness duration and persistent symptoms found no passage addressing that link. (LLM, conf=0.73)
Experimental — accuracy not yet measuredIn the EPOS statement, fever and elevated serum markers of inflammation (CRP or ESR) are included as diagnostic criteria for ARS.
“In the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) statement, fever and elevated serum markers of inflammation (C-reactive protein or erythrocyte sedimentation rate) are also included as diagnostic criteria.138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
The clinical definitions in §§2.1–2.2 (page numbers unavailable) list symptoms, endoscopic signs, and CT changes, but do not address fever or elevated CRP or ESR as ARS diagnostic criteria. Searches for fever, CRP, ESR, and inflammatory markers found no passage in our copy establishing the attributed criteria. (LLM, conf=0.74)
Experimental — accuracy not yet measuredViral ARS is generally present for less than 10 days.
“In general, viral ARS is present for less than 10 days.”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Section 2.2 identifies viral ARS with the common cold but gives no duration. Searches for “10 days,” “less than 10 days,” and the viral-versus-post-viral distinction found no passage in our copy establishing the claimed time limit. (LLM, conf=0.69)
Experimental — accuracy not yet measuredProgressive worsening over a short period (5 days) suggests bacterial ARS.
“Progressive worsening over a short period of time (ie, 5 days) is also suggestive of bacterial ARS.137,138”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [138]
Section 2.2 distinguishes post-viral from bacterial acute rhinosinusitis but does not say that worsening over five days suggests a bacterial cause. Searches for “5 days,” worsening symptoms, and bacterial diagnostic criteria found no passage addressing that indicator in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredNasal obstruction has a prevalence close to 30% in Europe.
“nasal obstruction has a prevalence close to the 30% in Europe”
From Role of Nasal Surgery in Adult Obstructive Sleep Apnea: A Systematic Review (2024) · cites this paper as [28]
The Introduction reports an overall European prevalence of 10.9% for chronic rhinosinusitis, with a range of 6.9–27.1%; it does not give a prevalence for nasal obstruction. Searches for nasal obstruction prevalence and a figure near 30% found no passage addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn some patients, there is increasing evidence of the involvement of a neurogenic signaling mechanism that causes the sensation of nasal obstruction in the absence of real obstruction of the nasal passages.
“In some patients, there is increasing evidence of the involvement of a neurogenic signaling mechanism that causes the sensation of NO in the absence of real obstruction of the nasal passages [20].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [20]
The clinical definition (section 2.1, p. 3) lists nasal blockage as a symptom, and the diagnosis section (3.3.2, p. 10) recommends examination. Neither addresses a neurogenic mechanism causing a sensation of obstruction without physical blockage. Searches for “neurogenic” and for subjective obstruction without physical blockage found no passage addressing that claim. (LLM, conf=0.73)
Experimental — accuracy not yet measuredEfficacy of intranasal chromones has not been demonstrated in patients with chronic rhinosinusitis and nasal polyps.
“Efficacy has not been demonstrated in patients with CRS and NP [130].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [130]
The CRSwNP management section (p. 7) discusses intranasal corticosteroids and doxycycline, but does not address intranasal chromones. Searches for chromones, cromolyn, cromoglycate, and mast-cell stabilizers found no passage assessing their efficacy in patients with CRS and nasal polyps. (LLM, conf=0.74)
Experimental — accuracy not yet measured
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European Position Paper on Rhinosinusitis and Nasal Polyps 2020
Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., Toppila-Salmi, S., Bernal-Sprekelsen, M., Mullol, J., Alobid, I., et al. (2020) · Rhinology journal · doi:10.4193/rhin20.600 · Cited by 5,882 · see citing works
Self-citationBachert, C., Han, J. K., Desrosiers, M. Y., Hellings, P. W., Amin, N., Lee, S. E., Mullol, J., Greos, L. S., Bosso, J. V., Laidlaw, T. M., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)31881-1 · Cited by 1,608 · see citing works
Self-citationClinical Practice Guideline (Update): Adult Sinusitis
Rosenfeld, R. M., Piccirillo, J. F., Chandrasekhar, S. S., Brook, I., Ashok Kumar, K., Kramper, M., Orlandi, R. R., Palmer, J. N., Patel, Z. M., Peters, A., et al. (2015) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599815572097 · Cited by 1,159 · see citing works
International consensus statement on allergy and rhinology: rhinosinusitis 2021
Orlandi, R. R., Kingdom, T. T., Smith, T. L., Bleier, B. S., DeConde, A. S., Luong, A., Poetker, D. M., Soler, Z. M., Welch, K. C., Wise, S. K., et al. (2020) · International Forum of Allergy & Rhinology · doi:10.1002/alr.22741 · Cited by 1,051 · see citing works
Self-citationInternational Consensus Statement on Allergy and Rhinology: Rhinosinusitis
Orlandi, R. R., Kingdom, T. T., Hwang, P. H., Smith, T. L., Alt, J. A., Baroody, F. M., Batra, P. S., Bernal‐Sprekelsen, M., Bhattacharyya, N., Chandra, R. K., et al. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21695 · Cited by 892 · see citing works
Self-citationBachert, C., Mannent, L., Naclerio, R. M., Mullol, J., Ferguson, B. J., Gevaert, P., Hellings, P., Jiao, L., Wang, L., Evans, R. R., et al. (2016) · JAMA · doi:10.1001/jama.2015.19330 · Cited by 794 · see citing works
Self-citationTargeting key proximal drivers of type 2 inflammation in disease
Gandhi, N. A., Bennett, B. L., Graham, N. M. H., Pirozzi, G., Stahl, N., & Yancopoulos, G. D. (2016) · Nature Reviews Drug Discovery · doi:10.1038/nrd4624 · Cited by 766 · see citing works
Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study
Tokunaga, T., Sakashita, M., Haruna, T., Asaka, D., Takeno, S., Ikeda, H., Nakayama, T., Seki, N., Ito, S., Murata, J., et al. (2015) · Allergy · doi:10.1111/all.12644 · Cited by 718 · see citing works
Adaptation of Pseudomonas aeruginosa to the cystic fibrosis airway: an evolutionary perspective
Folkesson, A., Jelsbak, L., Yang, L., Johansen, H. K., Ciofu, O., Høiby, N., & Molin, S. (2012) · Nature Reviews Microbiology · doi:10.1038/nrmicro2907 · Cited by 699 · see citing works
Immunopathogenesis of Chronic Rhinosinusitis and Nasal Polyposis
Schleimer, R. P. (2016) · Annual Review of Pathology Mechanisms of Disease · doi:10.1146/annurev-pathol-052016-100401 · Cited by 548 · see citing works
Akdis, C. A., Bachert, C., Cingi, C., Dykewicz, M. S., Hellings, P. W., Naclerio, R. M., Schleimer, R. P., & Ledford, D. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.02.036 · Cited by 538 · see citing works
Self-citationCommonality of the IL-4/IL-13 pathway in atopic diseases
Gandhi, N. A., Pirozzi, G., & Graham, N. M. H. (2017) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2017.1298443 · Cited by 493 · see citing works
Soyka, M. B., Wawrzyniak, P., Eiwegger, T., Holzmann, D., Treis, A., Wanke, K., Kast, J. I., & Akdis, C. A. (2012) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2012.05.052 · Cited by 486 · see citing works
The microbiome of the upper respiratory tract in health and disease
Kumpitsch, C., Koskinen, K., Schöpf, V., & Moissl‐Eichinger, C. (2019) · BMC Biology · doi:10.1186/s12915-019-0703-z · Cited by 471 · see citing works
An increased prevalence of self‐reported allergic rhinitis in major Chinese cities from 2005 to 2011
Wang, X. D., Zheng, M., Lou, H. F., Wang, C., Zhang, Y., Bo, M., Song, G., Zhang, N., Zhang, L., & Bachert, C. (2016) · Allergy · doi:10.1111/all.12874 · Cited by 425 · see citing works
Self-citationRoberts, G., Xatzipsalti, M., Borrego, L. M., Custovic, A., Halken, S., Hellings, P. W., Papadopoulos, N. G., Rotiroti, G., Scadding, G., Timmermans, F., et al. (2013) · Allergy · doi:10.1111/all.12235 · Cited by 416 · see citing works
Self-citationAcrylic acid/acrylamide based hydrogels and its properties - A review
Sennakesavan, G., Mostakhdemin, M., Dkhar, L., Seyfoddin, A., & Januddi, F. (2020) · Polymer Degradation and Stability · doi:10.1016/j.polymdegradstab.2020.109308 · Cited by 413 · see citing works
Wallmeier, J., Nielsen, K. G., Kuehni, C. E., Lucas, J. S., Leigh, M. W., Zariwala, M. A., & Omran, H. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0209-6 · Cited by 403 · see citing works
Bachert, C., Zhang, N., Holtappels, G., Lobel, L. D., Cauwenberge, P. V., Liu, S., Lin, P., Bousquet, J., & Steen, K. V. (2010) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.07.007 · Cited by 402 · see citing works
Self-citationOral steroids and doxycycline: Two different approaches to treat nasal polyps
Van Zele, T., Gevaert, P., Holtappels, G., Beule, A., Wormald, P. J., Mayr, S., Hens, G., Hellings, P., Ebbens, F. A., Fokkens, W., et al. (2010) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.02.020 · Cited by 402 · see citing works
Self-citationChronic Rhinosinusitis: Epidemiology and Burden of Disease
DeConde, A. S., & Soler, Z. M. (2016) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2016.30.4297 · Cited by 368 · see citing works
Diagnosis and management of NSAID ‐Exacerbated Respiratory Disease (N‐ ERD )—a EAACI position paper
Kowalski, M. L., Agache, I. O., Bavbek, S., Bakırtaş, A., Blanca, M., Bochenek, G., Bonini, M., Heffler, E. M., Klimek, L., Laidlaw, T. M., et al. (2018) · Allergy · doi:10.1111/all.13599 · Cited by 360 · see citing works
Self-citationBachert, C., Marple, B. F., Schlosser, R. J., Hopkins, C. L., Schleimer, R. P., Lambrecht, B. N., Bröker, B. M., Laidlaw, T. M., & Song, W. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-00218-1 · Cited by 341 · see citing works
Self-citationCanadian clinical practice guidelines for acute and chronic rhinosinusitis
Desrosiers, M., Evans, G. A., Keith, P. K., Wright, E. D., Kaplan, A., Bouchard, J., Ciavarella, A., Doyle, P. W., Javer, A. R., Leith, E. S., et al. (2011) · Allergy, Asthma & Clinical Immunology · doi:10.1186/1710-1492-7-2 · Cited by 313 · see citing works
Protein crystallization promotes type 2 immunity and is reversible by antibody treatment
Persson, E. K., Verstraete, K., Heyndrickx, I., Gevaert, E., Aegerter, H., Percier, J.-M., Deswarte, K., Verschueren, K. H. G., Dansercoer, A., Gras, D., et al. (2019) · Science · doi:10.1126/science.aaw4295 · Cited by 311 · see citing works
Self-citationStevens, W. W., Ocampo, C. J., Berdnikovs, S., Sakashita, M., Mahdavinia, M., Suh, L. A., Takabayashi, T., Norton, J. E., Hulse, K. E., Conley, D. B., et al. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201412-2278oc · Cited by 296 · see citing works
Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample
Hirsch, A. G., Stewart, W. F., Sundaresan, A. S., Young, A. J., Kennedy, T. L., Greene, J. S., Feng, W., Tan, B. K., Schleimer, R. P., Kern, R. C., et al. (2016) · Allergy · doi:10.1111/all.13042 · Cited by 291 · see citing works
Adult-onset asthma: is it really different?
de Nijs, S. B., Venekamp, L. N., & Bel, E. H. (2013) · European Respiratory Review · doi:10.1183/09059180.00007112 · Cited by 283 · see citing works
Predictive Significance of Tissue Eosinophilia for Nasal Polyp Recurrence in the Chinese Population
Lou, H., Meng, Y., Piao, Y., Wang, C., Zhang, L., & Bachert, C. (2015) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2015.29.4231 · Cited by 277 · see citing works
Self-citationPsaltis, A. J., Li, G., Vaezeafshar, R., Cho, K., & Hwang, P. H. (2014) · The Laryngoscope · doi:10.1002/lary.24654 · Cited by 277 · see citing works
Economics of Chronic Rhinosinusitis
Rudmik, L. R. (2017) · Current Allergy and Asthma Reports · doi:10.1007/s11882-017-0690-5 · Cited by 274 · see citing works
de Loos, D. A. E. D., Lourijsen, E. S., Wildeman, M. A., Freling, N. J. M., Wolvers, M. D. J., Reitsma, S., & Fokkens, W. J. (2018) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2018.12.986 · Cited by 273 · see citing works
Self-citationInvasive and Non-Invasive Fungal Rhinosinusitis—A Review and Update of the Evidence
Deutsch, P. G., Whittaker, J. D., & Prasad, S. R. (2019) · Medicina · doi:10.3390/medicina55070319 · Cited by 260 · see citing works
Eosinophilic chronic rhinosinusitis
Fujieda, S., Imoto, Y., Kato, Y., Ninomiya, T., Tokunaga, T., Tsutsumiuchi, T., Yoshida, K., Kidoguchi, M., & Takabayashi, T. (2019) · Allergology International · doi:10.1016/j.alit.2019.07.002 · Cited by 257 · see citing works
Incidence and associated premorbid diagnoses of patients with chronic rhinosinusitis
Tan, B. K., Chandra, R. K., Pollak, J., Kato, A., Conley, D. B., Peters, A. T., Grammer, L. C., Avila, P. C., Kern, R. C., Stewart, W. F., et al. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.02.002 · Cited by 256 · see citing works
Phenotypes and Emerging Endotypes of Chronic Rhinosinusitis
Bachert, C., & Akdiş, C. A. (2016) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2016.05.004 · Cited by 246 · see citing works
Self-citationPolverino, E., Dimakou, K., Hurst, J. R., Martínez‐García, M. Á., Miravitlles, M., Paggiaro, P., Shteinberg, M., Aliberti, S., & Chalmers, J. D. (2018) · European Respiratory Journal · doi:10.1183/13993003.00328-2018 · Cited by 243 · see citing works
Bachert, C., Pawankar, R., Zhang, L., Bunnag, C., Fokkens, W. J., Hamilos, D. L., Jirapongsananuruk, O., Kern, R. C., Meltzer, E. O., Mullol, J., et al. (2014) · World Allergy Organization Journal · doi:10.1186/1939-4551-7-25 · Cited by 242 · see citing works
Self-citationDeConde, A. S., Mace, J. C., Bodner, T., Hwang, P. H., Rudmik, L. R., Soler, Z. M., & Smith, T. L. (2014) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21408 · Cited by 240 · see citing works
Pathogenesis of nasal polyposis
Hulse, K. E., Stevens, W. W., Tan, B. K., & Schleimer, R. P. (2014) · Clinical & Experimental Allergy · doi:10.1111/cea.12472 · Cited by 237 · see citing works
Co‐morbidities in severe asthma: <scp>C</scp> linical impact and management
Porsbjerg, C., & Menzies‐Gow, A. (2017) · Respirology · doi:10.1111/resp.13026 · Cited by 233 · see citing works
Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis
Brietzke, S. E., Shin, J. J., Choi, S. S., Lee, J. T., Parikh, S. R., Peña, M. T., Prager, J. D., Ramadan, H. H., Veling, M. C., Corrigan, M. D., et al. (2014) · Otolaryngology · doi:10.1177/0194599814549302 · Cited by 228 · see citing works
Mucosal eosinophilia and recurrence of nasal polyps - new classification of chronic rhinosinusitis
Nakayama, T., Yoshikawa, M., Asaka, D., Okushi, T., Matsuwaki, Y., Otori, N., Hama, T., & Moriyama, H. (2011) · Rhinology Journal · doi:10.4193/rhino10.261 · Cited by 228 · see citing works
Unmet needs in severe chronic upper airway disease (SCUAD)
Bousquet, J., Bachert, C., Canonica, G. W., Casale, T. B., Cruz, Á. A., Lockey, R. J., & Zuberbier, T. (2009) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2009.06.027 · Cited by 225 · see citing works
Self-citationYoung, J., Sutter, A. D., Merenstein, D., van Essen, G. A., Kaiser, L., Varonen, H., Williamson, I. G., & Bucher, H. C. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60416-x · Cited by 221 · see citing works
Zele, T. V., Holtappels, G., Gevaert, P., & Bachert, C. (2014) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2014.28.4033 · Cited by 214 · see citing works
Self-citationCalus, L., Bruaene, N. V., Bosteels, C., Dejonckheere, S., Zele, T. V., Holtappels, G., Bachert, C., & Gevaert, P. (2019) · Clinical and Translational Allergy · doi:10.1186/s13601-019-0269-4 · Cited by 214 · see citing works
Self-citationEosinophilic Chronic Rhinosinusitis in Japan
Ishitoya, J., Sakuma, Y., & Tsukuda, M. (2010) · Allergology International · doi:10.2332/allergolint.10-rai-0231 · Cited by 212 · see citing works
The Microbiome of the Middle Meatus in Healthy Adults
Ramakrishnan, V. R., Feazel, L. M., Gitomer, S. A., Ir, D., Robertson, C. E., & Frank, D. N. (2013) · PLoS ONE · doi:10.1371/journal.pone.0085507 · Cited by 209 · see citing works
Physiology and pathophysiology of respiratory mucosa of the nose and the paranasal sinuses
Beule, A. G. (2010) · PubMed Central · doi:10.3205/cto000071 · Cited by 206 · see citing works
Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps
Bhattacharyya, N., Villeneuve, S., Joish, V. N., Amand, C., Mannent, L., Amin, N., Rowe, P., Maroni, J. M., Eckert, L., Yang, T., et al. (2019) · The Laryngoscope · doi:10.1002/lary.27852 · Cited by 201 · see citing works
Hox, V., Lourijsen, E. S., Jordens, A., Aasbjerg, K., Agache, I. O., Alobid, I., Bachert, C., Boussery, K., Campo, P., Fokkens, W. J., et al. (2020) · Clinical and Translational Allergy · doi:10.1186/s13601-019-0303-6 · Cited by 195 · see citing works
Self-citationSinus microbiota varies among chronic rhinosinusitis phenotypes and predicts surgical outcome
Ramakrishnan, V. R., Hauser, L. J., Feazel, L. M., Ir, D., Robertson, C. E., & Frank, D. N. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.02.008 · Cited by 187 · see citing works
Phenotypes and endotypes of rhinitis and their impact on management: a <scp>PRACTALL</scp> report
Papadopoulos, N. G., Bernstein, J. A., Demoly, P., Dykewicz, M., Fokkens, W., Hellings, P. W., Peters, A. T., Rondon, C., Togias, A., & Cox, L. S. (2015) · Allergy · doi:10.1111/all.12573 · Cited by 182 · see citing works
Self-citationJonstam, K., Swanson, B. N., Mannent, L., Cardell, L., Tian, N., Wang, Y., Zhang, D., Fan, C., Holtappels, G., Hamilton, J. D., et al. (2018) · Allergy · doi:10.1111/all.13685 · Cited by 182 · see citing works
Self-citationEvidence of microbiota dysbiosis in chronic rhinosinusitis
Hoggard, M., Biswas, K., Zoing, M., Mackenzie, B. W., Taylor, M. W., & Douglas, R. G. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21871 · Cited by 180 · see citing works
Self-citationEndotype-driven treatment in chronic upper airway diseases
Greve, G. D., Hellings, P. W., Fokkens, W. J., Pugin, B., Steelant, B., & Seys, S. (2017) · Clinical and Translational Allergy · doi:10.1186/s13601-017-0157-8 · Cited by 175 · see citing works
Self-citationRudmik, L., Hopkins, C., Peters, A., Smith, T. L., Schlosser, R. J., & Soler, Z. M. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.10.012 · Cited by 176 · see citing works
Self-citationKakli, H. A., & Riley, T. D. (2016) · Primary Care: Clinics in Office Practice · doi:10.1016/j.pop.2016.04.009 · Cited by 200 · see citing works
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Self-citationCellular phenotyping of chronic rhinosinusitis with nasal polyps
Lou, H., Meng, Y., Piao, Y., Zhang, N., Bachert, C., Wang, C., & Zhang, L. (2016) · Rhinology Journal · doi:10.4193/rhin15.271 · Cited by 170 · see citing works
Self-citationEAACI Task Force on Occupational Rhinitis, Moscato, G., Vandenplas, O., Gerth Van Wijk, R., Malo, J. L., Quirce, S., Walusiak, J., Castano, R., De Groot, H., Folletti, I., et al. (2008) · Allergy · doi:10.1111/j.1398-9995.2008.01801.x · Cited by 169 · see citing works
Complications in sinus lifting procedures: Classification and management
Molina, A., Sanz‐Sánchez, I., Sanz‐Martín, I., Ortiz‐Vigón, A., & Sanz, M. (2022) · Periodontology 2000 · doi:10.1111/prd.12414 · Cited by 169 · see citing works
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Self-citationKowalski, M. L., Ansotegui, I. J., Aberer, W., Al-Ahmad, M. S., Akdiş, M., Ballmer-Weber, B. K., Beyer, K., Blanca, M., Brown, S. G. A., Bunnag, C., et al. (2016) · World Allergy Organization Journal · doi:10.1186/s40413-016-0122-3 · Cited by 165 · see citing works
Self-citationFong, S., Drilling, A., Morales, S., Cornet, M., Woodworth, B. A., Fokkens, W. J., Psaltis, A. J., Vreugde, S., & Wormald, P. (2017) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2017.00418 · Cited by 162 · see citing works
Self-citationLocal receptor revision and class switching to IgE in chronic rhinosinusitis with nasal polyps
Gevaert, P., Nouri‐Aria, K. T., Wu, H., Harper, C., Takhar, P., Fear, D. J., Acke, F. R. E., Ruyck, N. D., Banfield, G., Kariyawasam, H. H., et al. (2012) · Allergy · doi:10.1111/all.12054 · Cited by 162 · see citing works
Self-citationBousquet, J., Hellings, P. W., Agache, I. O., Amat, F., Annesi‐maesano, I., Ansotegui, I. J., Antó, J. M., Bachert, C., Bateman, E., Bedbrook, A., et al. (2018) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2018.08.049 · Cited by 170 · see citing works
Self-citationKohanski, M. A., Workman, A. D., Patel, N. N., Hung, L.-Y., Shtraks, J. P., Chen, B., Blasetti, M., Doghramji, L., Kennedy, D. W., Adappa, N. D., et al. (2018) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2018.03.019 · Cited by 159 · see citing works
Self-citationIL-25 as a novel therapeutic target in nasal polyps of patients with chronic rhinosinusitis
Shin, H., Kim, D., Park, M., Eun, K. M., Lee, M., So, D., Kong, I. G., Mo, J., Yang, M., Jin, H. R., et al. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.01.003 · Cited by 158 · see citing works
Epidemiology and Differential Diagnosis of Nasal Polyps
Chaaban, M. R., Walsh, E. M., & Woodworth, B. A. (2013) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2013.27.3981 · Cited by 159 · see citing works
Identification of IL-17F/frequent exacerbator endotype in asthma
Ricciardolo, F. L. M., Sorbello, V., Folino, A., Gallo, F., Massaglia, G. M., Favatà, G., Conticello, S., Vallese, D., Gani, F., Malerba, M., et al. (2016) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2016.10.034 · Cited by 157 · see citing works
Ho, J., Bailey, M., Zaunders, J. J., Mrad, N., Sacks, R., Sewell, W. A., & Harvey, R. J. (2014) · Clinical & Experimental Allergy · doi:10.1111/cea.12462 · Cited by 153 · see citing works
Self-citationHu, Y., Cao, P., Liang, G., Cui, Y., & Liu, Z. (2012) · The Laryngoscope · doi:10.1002/lary.22507 · Cited by 151 · see citing works
Ahn, J.-C., Kim, J.-W., Lee, C. H., & Rhee, C.-S. (2016) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2015.3142 · Cited by 146 · see citing works
Medical Therapies for Adult Chronic Sinusitis: A Systematic Review
Rudmik, L., & Soler, Z. M. (2015) · JAMA · doi:10.1001/jama.2015.7544 · Cited by 166 · see citing works
Walford, H. H., Lund, S. J., Baum, R. E., White, A. A., Bergeron, C. M., Husseman, J. W., Bethel, K. J., Scott, D. R., Khorram, N., Miller, M., et al. (2014) · Clinical Immunology · doi:10.1016/j.clim.2014.09.007 · Cited by 145 · see citing works
Phenotypes of Chronic Rhinosinusitis
Cho, S., Hamilos, D. L., Han, D. H., & Laidlaw, T. M. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2019.12.021 · Cited by 145 · see citing works
Mixed T Helper Cell Signatures In Chronic Rhinosinusitis with and without Polyps
Derycke, L., Eyerich, S., Crombruggen, K. V., Perez-Novo, C. A., Holtappels, G., Ruyck, N. D., Gevaert, P., & Bachert, C. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097581 · Cited by 141 · see citing works
Self-citationPoetker, D. M., Jakubowski, L. A., Lal, D., Hwang, P. H., Wright, E. D., & Smith, T. L. (2012) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21072 · Cited by 137 · see citing works
Type 2 inflammation in chronic rhinosinusitis without nasal polyps: Another relevant endotype
Delemarre, T., Holtappels, G., Ruyck, N. D., Zhang, N., Nauwynck, H., Bachert, C., & Gevaert, E. (2020) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2020.04.040 · Cited by 136 · see citing works
Self-citationCystic Fibrosis Chronic Rhinosinusitis: A Comprehensive Review
Chaaban, M. R., Kejner, A. E., Rowe, S. M., & Woodworth, B. A. (2013) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2013.27.3919 · Cited by 135 · see citing works
Pathophysiologic mechanisms of chronic rhinosinusitis and their roles in emerging disease endotypes
Cao, P.-P., Wang, Z.-C., Schleimer, R. P., & Liu, Z. (2018) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2018.10.014 · Cited by 135 · see citing works
Lai, K., Shen, H., Zhou, X., Qiu, Z., Shaoxi, C., Huang, K., Wang, Q., Wang, C., Lin, J., Hao, C., et al. (2018) · Journal of Thoracic Disease · doi:10.21037/jtd.2018.09.153 · Cited by 133 · see citing works
The prevalence of olfactory dysfunction in chronic rhinosinusitis
Kohli, P., Naik, A. N., Harruff, E. E., Nguyen, S. A., Schlosser, R. J., & Soler, Z. M. (2016) · The Laryngoscope · doi:10.1002/lary.26316 · Cited by 133 · see citing works
Self-citationAdaptive immune responses in Staphylococcus aureus biofilm–associated chronic rhinosinusitis
Foreman, A., Holtappels, G., Psaltis, A. J., Jervis-Bardy, J., Field, J., Wormald, P., & Bachert, C. (2011) · Allergy · doi:10.1111/j.1398-9995.2011.02678.x · Cited by 132 · see citing works
Self-citationStaphylococcus aureus Induces a Mucosal Type 2 Immune Response via Epithelial Cell–derived Cytokines
Lan, F., Zhang, N., Holtappels, G., Ruyck, N. D., Krysko, O., Crombruggen, K. V., Braun, H., Johnston, S. L., Papadopoulos, N. G., Zhang, L., et al. (2018) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201710-2112oc · Cited by 132 · see citing works
Self-citationRudmik, L., Soler, Z. M., Mace, J. C., Schlosser, R. J., & Smith, T. L. (2015) · The Laryngoscope · doi:10.1002/lary.24916 · Cited by 130 · see citing works
Self-citationMcHugh, T., Snidvongs, K., Xie, M., Banglawala, S. M., & Sommer, D. D. (2018) · International Forum of Allergy & Rhinology · doi:10.1002/alr.22194 · Cited by 130 · see citing works
Chronic Maxillary Rhinosinusitis of Dental Origin: A Systematic Review of 674 Patient Cases
Lechien, J. R., Filleul, O., de Araujo, P. C., Hsieh, J. W., Chantrain, G., & Saussez, S. (2014) · International Journal of Otolaryngology · doi:10.1155/2014/465173 · Cited by 129 · see citing works
Mechanisms and biomarkers of inflammatory endotypes in chronic rhinosinusitis without nasal polyps
Klingler, A. I., Stevens, W. W., Tan, B. K., Peters, A. T., Poposki, J. A., Grammer, L. C., Welch, K. C., Smith, S. S., Conley, D. B., Kern, R. C., et al. (2020) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2020.11.037 · Cited by 127 · see citing works
Systemic corticosteroids for acute sinusitis
Venekamp, R. P., Thompson, M., Hayward, G., Heneghan, C. J., Mar, C. D., Perera, R., Glasziou, P., & Rovers, M. M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008115.pub3 · Cited by 126 · see citing works
National burden of antibiotic use for adult rhinosinusitis
Smith, S. S., Evans, C. T., Tan, B. K., Chandra, R. K., Smith, S. B., & Kern, R. C. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.07.009 · Cited by 123 · see citing works
A loss-of-function variant in ALOX15 protects against nasal polyps and chronic rhinosinusitis
Kristjansson, R. P., Benónísdóttir, S., Davidsson, O. B., Oddsson, Á., Tragante, V., Sigurdsson, J. K., Stefánsdóttir, L., Jonsson, S., Jensson, B. Ö., Arthur, J. G., et al. (2019) · Nature Genetics · doi:10.1038/s41588-018-0314-6 · Cited by 123 · see citing works
Danger points, complications and medico-legal aspects in endoscopic sinus surgery
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Chronic rhinosinusitis: Endotypes, biomarkers, and treatment response
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Inflammatory Patterns in Upper Airway Disease in the Same Geographical Area may Change over Time
Katotomichelakis, M., Tantilipikorn, P., Holtappels, G., Ruyck, N. D., Lan, F., Zele, T. V., Muangsomboon, S., Jareonchasri, P., Bunnag, C., Danielides, V., et al. (2013) · American Journal of Rhinology and Allergy · doi:10.2500/ajra.2013.27.3922 · Cited by 118 · see citing works
Self-citationThe activation and function of IL-36γ in neutrophilic inflammation in chronic rhinosinusitis
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Self-citation
- Authors
- Fokkens, W. J., Lund, V. J., Mullol, J., Bachert, C., Alobid, I., Baroody, F., Cohen, N., Cervin, A., Douglas, R., Gevaert, P., Georgalas, C., Goossens, H., Harvey, R., Hellings, P., Hopkins, C., Jones, N., Joos, G., Kalogjera, L., Kern, B., Kowalski, M., Price, D., Riechelmann, H., Schlosser, R., Senior, B., Thomas, M., Toskala, E., Voegels, R., Wang, D. Y., & Wormald, P. J.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Royal National Throat Nose and Ear Hospital (GB)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Ghent University (BE)
- University of Chicago (US)
- University of Pennsylvania (US)
- Lund University (SE)
- Auckland City Hospital (NZ)
- University of Amsterdam (NL)
- University of Antwerp (BE)
- UNSW Sydney (AU)
- KU Leuven (BE)
- Guy's Hospital (GB)
- University of Nottingham (GB)
- University of Zagreb (HR)
- Northwestern University (US)
- Medical University of Lodz (PL)
- University of Aberdeen (GB)
- Innsbruck Medical University (AT)
- Medical University of South Carolina (US)
- University of Southampton (GB)
- Universidade de São Paulo (BR)
- National University of Singapore (SG)
- Flinders University (AU)
- ORCID
- Venue
- Rhinology journal
- Publisher
- Stichting Nase
- Published
- 2012-03-01
- Volume
- 50
- Issue
- 1
- Pages
- 1-12
- ISSN
- 0300-0729 (ISSN-L)
- OpenAlex
- W1885435857
- Cited by
- 2,387
- References
- 51
- Citations by year
- 2026: 39 · 2025: 83 · 2024: 104 · 2023: 100 · 2022: 140 · 2021: 166 · 2020: 243 · 2019: 248 · 2018: 215 · 2017: 189 · 2016: 185 · 2015: 193 · 2014: 156 · 2013: 121 · 2012: 79
- FWCI
- 171.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Rhinology Journal (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Keywords
- sinusitis, nasal polyps, chronic rhinosinusitis without nasal polyps, chronic rhinosinusitis with nasal polyps, acute sinusitis, cystic fibrosis, aspirin-exacerbated respiratory disease, immunodeficiency, allergic fungal rhinosinusitis, inflammatory mechanisms, disease management
- MeSH terms
- Adult, Child, Chronic Disease, Humans, Nasal Polyps, Rhinitis, Sinusitis, Practice Guidelines as Topic
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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