Economics of Chronic Rhinosinusitis

Rudmik, Luke

doi:10.1007/s11882-017-0690-5

Cited by 182 publications

(163 citation statements)

References 79 publications

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“…CRS negatively impacts quality of life through chronic symptomatology, acute exacerbations of symptoms, as well as exacerbation of comorbid pulmonary disease . Billions of dollars in cost are associated with direct expenses related to medications and physician visits as well as indirect expenses related to missed work or lost productivity …”

Section: Introductionmentioning

confidence: 99%

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Husain

Sedaghat

2019

Clinical Otolaryngology

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Background Chronic rhinosinusitis (CRS) is the downstream manifestation of heterogeneous pathophysiologic mechanisms leading to chronic sinonasal inflammation. Traditional grouping of patients by symptoms or clinical findings/phenotypes is being replaced by classification of CRS patients based on the underlying pathophysiologic mechanisms: endotypes. Objective of Review To provide an up‐to‐date review on the current knowledge of CRS endotypes with a focus on how the pathophysiologic mechanisms defined by each endotype may be targeted therapeutically. Special emphasis is placed on the clinical relevance of the material and how it may inform the current practice of otolaryngologists. Type of Review A systematic review of contemporary literature review focusing on the latest studies examining the role of endotypes in the management and treatment of CRS. Search Strategy A MEDLINE and PubMed Central search were undertaken to perform this review using the keywords “Endotype” and “Sinusitis.” Evaluation Method Articles containing the keywords, as well as the references of those articles, were then examined for relevance. Results The endotypes for CRS are often defined based on the balance of T‐helper cell patterns of inflammation and can be grouped into Th2 and non‐Th2 inflammation. These groups have shown a variable response to medical and surgical therapy, demonstrating that existing mainstream treatments can be tailored to patients with specific endotypes. The inflammatory mediators of Th2 inflammation, IL‐4, IL‐5 and IL‐13 as well as IgE, are targeted by available biologic drugs that can be used for treatment of refractory disease. Conclusions Increased understanding of CRS endotypes has led to the identification of biomarkers that define these endotypes and act as targets for potential therapeutics. Increasing knowledge about characteristics associated with these endotypes and their responses to treatments, including both established mainstream CRS treatments and novel biologic medications, has allowed incorporation of CRS endotypes into the current clinical decision‐making. Treatment of CRS patients based on consideration of their endotypes is therefore not only presently possible but may improve clinical outcomes of those patients as well.

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Section: Introductionmentioning

confidence: 99%

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Husain

Sedaghat

2019

Clinical Otolaryngology

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“…Dollars (USD) annually, and indirect costs such as from lost productivity, estimated to be $13.2 billion 2016 USD annually. 5–8 Given the large direct and indirect costs associated with the disease of CRS, surgical management with ESS has been demonstrated to be cost-effective compared to ongoing medical management for select patients, particularly those with recalcitrant disease. 2,6–12 ESS is also associated with significant improvements in health state utility values both in the short-term and long-term for patients with CRS.…”

Section: Introductionmentioning

confidence: 99%

Operative time and cost variability for functional endoscopic sinus surgery

Thomas

Smith

Newberry

et al. 2018

Int Forum Allergy Rhinol

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“…Chronic rhinosinusitis (CRS) is a complex and common syndrome affecting up to 16% of the United States population [1]. CRS invokes a direct treatment cost estimated between $10–13 billion per year in the US and CRS patients suffer from significantly impaired quality of life [2].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Role of Biofilms and Superantigens in Chronic Rhinosinusitis

Maina

Patel

Cohen

2018

Curr Otorhinolaryngol Rep

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Purpose of review: This review explores recent discoveries in our understanding of how biofilms and superantigens contribute to the pathogenesis of chronic rhinosinusitis (CRS). It also examines clinical implications and novel treatment approaches for biofilm associated CRS. Recent findings: While the role of biofilms in CRS has been studied for 14 years, research interest has now turned toward elucidating new methods of biofilm detection, microbial diversity, and novel treatment approaches. Recent studies on biofilm superantigens aim to clarify the immunological mechanisms of upper airway inflammation, particularly the type-2 response seen in nasal polyposis. Summary: Biofilms are a topic of research interest for their role in the pathogenesis of chronic rhinosinusitis, particularly when they elute superantigens. New studies on this topic focus on the molecular and cellular mechanisms at play.

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Economics of Chronic Rhinosinusitis

Cited by 182 publications

References 79 publications

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Understanding and clinical relevance of chronic rhinosinusitis endotypes

Operative time and cost variability for functional endoscopic sinus surgery

Understanding the Role of Biofilms and Superantigens in Chronic Rhinosinusitis

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