European position paper on rhinosinusitis and nasal polyps 2007.
European position paper on rhinosinusitis and nasal polyps 2007.
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发表时间：
2007
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通讯作者：
W. Fokkens;V. Lund;J. Mullol
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作者：
W. Fokkens;V. Lund;J. Mullol
鼻窦炎是一个重要的和日益增长的健康问题，导致社会的巨大经济负担。这份基于证据的立场文件描述了关于鼻窦炎和鼻息肉的已知信息，提供了基于证据的诊断和治疗建议，并考虑了我们如何在这一领域的研究中取得进展。鼻炎和鼻窦炎通常共存，并在大多数人并发;因此，正确的术语是鼻窦炎。鼻窦炎鼻息肉（包括鼻息肉）是指鼻子及鼻窦发炎，并有两种或以上的病征，其中一种是鼻塞/阻塞/鼻塞或流鼻涕（前/后鼻滴涕），+/-面部疼痛/压力，+/-嗅觉减退或丧失;以及息肉和/或粘液脓性分泌物的内镜体征，主要来自中鼻道和/或;主要在中鼻道的水肿/粘膜阻塞，和/或CT变化显示窦口鼻道复合体和/或鼻窦内的粘膜变化。本文对流行病学、一线和二线治疗以及研究给出了不同的定义。本文还介绍了成人和儿童急慢性鼻窦炎和鼻息肉病的解剖学和病理生理学、流行病学和诱发因素、炎症机制、循证诊断、内科和外科治疗。为一线和二线临床医生提供了基于证据的诊断和治疗方案。此外，还关注慢性鼻窦炎和鼻息肉的并发症和社会经济成本。最后但并非最不重要的是，与下气道的关系进行了讨论。
Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we can make progress with research in this area. Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Rhinosinusitis (including nasal polyps) is defined as inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip), +/- facial pain/pressure, +/- reduction or loss of smell; and either endoscopic signs of polyps and/or mucopurulent discharge primarily from middle meatus and/or; oedema/mucosal obstruction primarily in middle meatus, and/or CT changes showing mucosal changes within the ostiomeatal complex and/or sinuses. The paper gives different definitions for epidemiology, first line and second line treatment and for research. Furthermore the paper describes the anatomy and (patho)physiology, epidemiology and predisposing factors, inflammatory mechanisms, evidence based diagnosis, medical and surgical treatment in acute and chronic rhinosinusitis and nasal polyposis in adults and children. Evidence based schemes for diagnosis and treatment are given for the first and second line clinicians. Moreover attention is given to complications and socio-economic cost of chronic rhinosinusitis and nasal polyps. Last but not least the relation to the lower airways is discussed.