Management of patients with chronic rhinosinusitis with nasal polyps in Spain: learnings from a nationwide survey of otorhinolaryngologists

• Published in: European archives of oto-rhino-laryngology Vol. 281; no. 1; pp. 227 - 235
• Main Authors: Alobid, Isam, Liesa, Rafael Fernández, Aubá, Jose Miguel Villacampa, Moure, Abraham L., Sánchez-Herrero, M. Guadalupe, del Cuvillo Bernal, Alfonso
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2024
• Subjects: Chronic Disease; Cross-Sectional Studies; Head and Neck Surgery; Humans; Medicine; Medicine & Public Health; Nasal Polyps - complications; Nasal Polyps - diagnosis; Nasal Polyps - surgery; Neurosurgery; Otorhinolaryngology; Quality of Life; Rhinitis - complications; Rhinitis - diagnosis; Rhinitis - surgery; Rhinology; Rhinosinusitis; Sinusitis - complications; Sinusitis - diagnosis; Sinusitis - therapy; Spain - epidemiology; Surveys and Questionnaires; Spain; Nose diseases; Patient reported outcome measures; Surveys and Questionnaires; Inflammation; Biological therapy; Nasal polyps
• ISSN: 0937-4477; 1434-4726; 1434-4726
• DOI: 10.1007/s00405-023-08185-5

Purpose To describe the self-reported practices on the diagnosis, treatment, and follow-up of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) by ear, nose, and throat (ENT) specialists in Spain to identify potential areas for management optimization. Methods A cross-sectional online survey with 16 questions was carried out. Recruitment was performed by emailing registered ENT specialists in the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC). Results In total, 127 ENT specialists completed the survey. Fifty-one percent of respondents combined clinical criteria and objective evidence of mucosal inflammation to diagnose CRSwNP. Patient interview and, to a lower degree, a visual analogue scale were the most employed diagnostic tools to quantify symptom severity. Less than half (45%) routinely used the 22-item sino-nasal outcomes test (SNOT-22) to assess the impact of CRSwNP disease in quality of life. The use of patient-reported outcomes and other clinical evaluation tools showed a larger uptake among ENT specialists that worked at an ENT department with an available rhinology unit. Almost all the specialists surveyed (95%) recommended biological treatment, particularly in patients with uncontrolled CRSwNP with respiratory comorbidities (76%), as well as in candidates for revision surgery (66%). Conclusion Spanish otorhinolaryngologists showed a trend toward incorporating CRSwNP guideline recommendations in their clinical practice. The observed low uptake of patient-reported outcomes and objective clinical evaluation tools in routine clinical practise have been identified as areas for optimizing the management of patients with CRSwNP.