International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

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

Pulmonary Function of Patients with Chronic Rhinosinusitis and the Impact of Endoscopic Sinus Surgery

Abstract Background There is growing evidence that chronic rhinosinusitis (CRS) may be associated with lower airway manifestations. The difference in pulmonary function between normal individuals and patients with CRS and whether endoscopic sinus surgery (ESS) has a positive effect on the lower airway still remains controversial. The aim of this study was to compare pulmonary function tests (PFTs) in normal individuals and CRS patients and to investigate the outcomes of ESS on PFTs in patients with CRS. Patients and Methods A prospective study was carried out on 25 normal adults (group I) and 25 adult CRS patients (group II). PFTs were used to compare the lower airway condition between the two groups. Another comparison in PFTs was made in patients with CRS to evaluate the effectiveness of ESS at 1 week preoperatively and 1 month, postoperatively. Results In group I, all participants had forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC) of at least 80%, with a mean of 0.84±0.07, compared with the preoperative FEV1/FVC values of group II, which ranged from 61 to 70% in five (20%) patients, from 71 to 79% in 10 (40%) patients, and were equal to or higher than 80% in 10 (20%) patients. FEV1/FVC was significantly lower in group II patients than in group I participants (P=0.04). At 1 month postoperatively, the FEV1/FVC values of group II ranged from 61 to 70% in two (8%) patients, from 71 to 79% in 13 (52%) patients, and were equal to or higher than 80% in 12 (48%) patients; the mean FEV1/FVC was 0.9±0.50. These values were significantly higher (P=0.02) compared with the preoperative values. Conclusion This study provides corroborative objective evidence that patients with CRS may have nonmanifest lower airway infection compared with normal individuals and ESS is efficacious in the improvement of such infection