Choosing Wisely Canada rhinology recommendations

Arnstead, Neil; Chan, Yvonne; Kilty, Shaun; Ganeshathasan, Ragavan; Rahmani, Armin; Monteiro, Eric

doi:10.1186/s40463-020-00406-9

Cited by 9 publications

(11 citation statements)

References 16 publications

(26 reference statements)

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“…There are many symptoms and signs potentially associated with ARS, including sneezing, malaise, fever, cough, nasal discharge, nasal obstruction, cough, sore throat and headache, however many of these are nonspecific and can also be seen in isolated nasal infection or inflammation as well as with allergy flares 299,301,303,307–309 . The 3 cardinal symptoms and signs that otolaryngology, rhinology, and infectious disease experts have agreed upon to diagnose ARS are: up to 4 weeks of purulent nasal drainage, accompanied by nasal obstruction, or facial pain/pressure/fullness, or both 26,31,88,146,310 . These cardinal symptoms and signs do not have high level of evidence backing them up but instead have been agreed upon multiple times over many years by various task forces and consensus groups.…”

Section: Acute Rhinosinusitis (Ars)mentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

458

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: Acute Rhinosinusitis (Ars)mentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

458

479

View full text Add to dashboard Cite

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“…Sinusitisi su upale paranazalnih sinusa i mogu biti infektivne, alergijske ili autoimune prirode [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] . Najčešće se javljaju istovremeno sa upalama sluzokože nosne šupljine, te je adekvatniji naziv rinosinusitis 1 .…”

Section: Uvodunclassified

Effects of different antibiotics in the treatment of acute rhinosinusitis

Bojanović¹,

Živković-Marinkov²,

Stamenković³

et al. 2022

Acta stomatologica Naissi

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Introduction: Sinusitis is an inflammation of the paranasal sinuses and it can be infectious, allergic or autoimmune. Acute rhinosinusitis commonly has viral origin and occurs as part of the upper respiratory tract infections. The most common pathogens are Streptococcus, Pneumococcus and Haemophilus influenzae. Some inflammations may start as viral, but develop into bacterial superinfection, i.e., subsequent colonization of the bacteria in 0.5-2% of cases. Viral sinusitis lasts for 7-10 days, whereas bacterial may take longer. The aim: The aim of this study was to compare three therapeutic protocols for the treatment of acute bacterial rhinosinusitis. Materials and Methods: A prospective clinical study was conducted at the Ear, Nose and Throat Clinic, Clinical Center Nis from October 2019 to January 2020, and it involved patients with acute bacterial rhinosinusitis in whom we compared the efficiency and safety of levofloxacin administration for five and 10 days with the efficiency of amoxicillin clavulanate treatment. The study included 62 patients with documented clinical and radiological symptoms. Results: Confirmation of bacterial etiology is not routinely performed in clinical practice since it requires antral puncture or endoscopic examination of the middle nasal meatus. Consequently, the choice of antibiotic therapy is empiric. In our study, we used levofloxacin for five (500 mg once a day) and 10 days (500 mg once a day) and amoxicillin-clavulanatefor 10 days (500 mg-125 mg three times a day), and the results showed no statistically significant difference in regard to the choice of antibiotics and the duration of therapy. Conclusion: The findings of this study suggest that a short course of antibiotic treatment has similar efficiency compared to a longer course of treatment of patients with uncomplicated acute bacterial sinusitis when treatment is indicated.

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“…These consensus recommendations are an important step in standardizing the management of acute rhinosinusitis (ARS) and nasal fractures. We believe that standardization is important not only in the diagnosis and treatment of complex diseases like ARS and CRS, but also in the measure of treatment outcomes [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

Saydy

Moubayed

Bussières

et al. 2021

J of Otolaryngol - Head & Neck Surg

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Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract

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Choosing Wisely Canada rhinology recommendations

Cited by 9 publications

References 16 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Effects of different antibiotics in the treatment of acute rhinosinusitis

What is the optimal outcome after endoscopic sinus surgery in the treatment of chronic rhinosinusitis? A consultation of Canadian experts

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