Asia-Pacific survey of physicians’ perceptions and managements of chronic rhinosinusitis
Shan Shao,1 Ming Zheng,2 Xiangdong Wang,2,3 Amir HA Latiff,4 Dong Young Kim,5 Jiu Yao Wang,6 Marysia Recto,7 Michaela Lucas,8,9 Munkhbayarlakh Sonomjamts,10 Narantsetseg Logi,11 Niken Lestari,12 Nina Irawati,13 Pongsakorn Tantilipikorn,14 Samir Bhargava,15 Soumya MS,16 Takeshi Shimizu,17 Ting Fan Leung,18 Wasu Kamchaisatian,19 Ruby Pawankar,20 Luo Zhang2,3
1 Department of Otorhinolaryngology Head and Neck Surgery, Beijing Youan Hospital, Capital Medical University, Beijing, China
2 Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
3 Beijing Institute of Otolaryngology, Beijing Key Laboratory of Nasal diseases, Beijing, China
4 Allergy & Immunology Centre, Pantai Hospital, Kuala Lumpur, Malaysia
5 Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
6 Center for Allergy and Clinical Immunology Research, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
7 Division of Allergy and Immunology – Department of Pediatrics, Philippine General Hospital, Manila, Philippines
8 Medical School, University of Western Australia, Western Australia, Australia
9 Department of Immunology, Sir Charles Gairdner Hospital and Pathwest Laboratory Medicine, Western Australia, Australia
10 Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
11 Mongolian National University of Medical Sciences: Ulaanbaatar, Ulaanbaatar, Mongolia
12 Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
13 Awal Bros Hospital, Batam, Riau Island, Indonesia
14 Rhinology & Allergy Division, Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
15 Department of Otolaryngology – Head and Neck Surgery, HBT Medical College and Dr. R.N. Cooper Municipal General Hospital, Maharashtra, India
16 Department of ENT, St John’s Medical College Hospital, Bangalore, India
17 Department of Neurosurgery, Kansai Rosai Hospital, Hyogo, Japan
18 Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
19 Division of Allergy and Clinical Immunology, Pediatrics Department, Samitivej Children’s Hospital, Bangkok, Thailand
20 Department of Pediatrics, Nippon Medical School, Tokyo, Japan
Abstract
Background: The diagnosis and management of patients with chronic rhinosinusitis (CRS) may vary between otolaryngologists and allergists. Moreover, the adherence of different practitioners to European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS)2020 guideline recommendations has not been previously ascertained in Asia-Pacific regions.
Objective: Different specialists’ perceptions and managements of CRS in Asia-Pacific regions were assessed in an attempt to gauge these practices against EPOS2020 guidelines.
Methods: A transregional, cross-sectional survey was conducted to assess otolaryngologists’ and allergists’ perceptions and managements of CRS with regard to diagnosis, management and adherence to EPOS2020 guidelines.
Results: Sixteen physicians in Asia-Pacific regions responded to the questionnaire. A total of 71.4% of otolaryngologists preferred to diagnose CRS with a combination of positive nasal symptoms and nasal endoscopy plus sinus CT, whereas 22.2% of allergists took such criterion to diagnose CRS. Compared to allergists, otolaryngologists more often considered the endotype classification (85.8% versus 55.5%). For the preferred first-line treatment, in addition to intranasal corticosteroids recommended by all respondents, 66.7% of allergists preferred antihistamines, whereas 71.4% of otolaryngologists preferred nasal saline irrigation. Regarding the proper timing of surgery, 71.4% of otolaryngologists reported 8-12 weeks of treatment after the initiation of medication, while more than half of the allergists recommended 4-6 weeks of medical treatment.
Conclusion: This survey shows that variable perceptions and practices for CRS may exist between physicians with different specialties and highlights the need for increased communication and awareness between otolaryngologists and allergists to improve the diagnosis and treatment of CRS.
Key words: Chronic rhinosinusitis, otolaryngologists, allergists, diagnosis, treatment