Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics| ACTA Otorhinolaryngologica Italica
Online First
DOI: 10.14639/0392-100X-N2422
Rhinology
Published: 2023-05-23
download
PDF Supplementary file

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy
Otorhinolaryngology Unit, Head and Neck Department, Dipartimento di Scienze della Salute, Università degli Studi di Milano, ASST Santi Paolo e Carlo Hospital, Milan, Italy
Department of Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat, “Federico II” University, Naples, Italy
Department of Neuroscience DNS, Otolaryngology Section, University of Padua, Padua, Italy
Otorhinolaryngology Unit, Head and Neck Department, ASST Sette Laghi and UPLOAD Research Center, University of Insubria, Varese, Italy
Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Dipartimento di scienze odontostomatologiche e maxillo facciali, Sapienza University of Rome, Rome, Italy;
Department of Otolaryngology – Head and Neck Surgery, University Hospital of Modena, Modena, Italy
Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Pisa, Italy
Catholic University of The Sacred Heart, Rome, Italy
UOC di Otorinolaringoiatria IRCCS Policlinico San Martino Genova, Dipartimento DISC Università di Genova, Genoa, Italy
ENT Unit “Bellaria” Hospital – Specialized Dep AUSL Bologna, Italy
ENT Unit Department “G.F. Ingrassia” – Catania University, Italy
ENT Division, Maggiore Hospital, Eastern Piedmont University, Novara, Italy
ENT Department, San Camillo‑Forlanini Hospital, Rome, Italy
ENT Unit, Vito Fazzi Hospital, ASL Lecce, Italy
ENT Unit Department of Medical and Surgical Sciences, University Magna Græcia Catanzaro, Italy
ENT University of Insubria, ASST Settelaghi, Varese, Italy
IRCCS Humanitas Research Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Rozzano (MI), Italy
Otorhinolaryngology – Head and Neck Surgery, University of Campania “L. Vanvitelli”, Naples, Italy
Department of Head‑Neck Surgery, Otolaryngology, Head‑Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
Department Otorhinolaryngology, Hospital of Barletta, Barletta (BT), Italy
ENT Division, Maggiore Hospital, Eastern Piedmont University – Novara, Italy
Department of Otolaryngology, Ospedale Niguarda, Milan, Italy
Otorinolaringoiatria e audiologia, Università degli studi di Messina, Messina, Italy
https://orcid.org/0000-0001-5476-8056
Division of Otolaryngology, Ospedale Civile di Pordenone, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
Otorinolaringoiatria Azienda USL di Reggio Emilia/IRCCS, Italy
Dipartimento di scienze odontostomatologiche e maxillo facciali, Sapienza University of Rome, Rome, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia – University of Brescia, Brescia, Italy
Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
IFOS Former President and Executive Board member, Rome, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.
Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.
Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy; Otorhinolaryngology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.
biologics practical recommendation chronic rhinosinusitis nasal polyps Type 2 inflammation

Abstract

Objective. We conducted a national survey to understand how rhinology practice has changed with the advent of biologics and how this affected patients with uncontrolled, severe chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to analyse the results of the survey and infer practical recommendations for clinical practice.
Methods. A group of ear, nose, and throat specialists (ENTs) experienced in the management of CRSwNP developed a 74‑question survey. ENTs from rhinology centres authorised to prescribe biologics in the context of the national health system were invited to answer it between 01/05/2022 and 31/07/2022. The responses underwent descriptive analyses, and the authors discussed the results and derived practical recommendations for clinical practice.
Results. ENTs working in rhinology centres changed their practices coinciding with the advent of biologics. CRSwNP evaluations have become more complex because they involve diagnostic confirmation, determining the patients’ immunologic profile, and other factors. We observed heterogenous behaviours in practice that may be conditioned by the novelty of the topic. The results of the survey were used to develop practical recommendations for ENTs and are summarised herein.
Conclusions. Clinical practice in rhinology outpatient clinics has changed profoundly in the era of biologics. Our practical recommendations for clinicians working in rhinology centres are expected to help standardise practice and improve care.

Document supported by the Joint Committee on Biologics in Rhinology and by the Italian Rhinology Committee of the Italian Society of Otorhinolaryngology.

Affiliations

Eugenio De Corso

Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy

Carlotta Pipolo

Otorhinolaryngology Unit, Head and Neck Department, Dipartimento di Scienze della Salute, Università degli Studi di Milano, ASST Santi Paolo e Carlo Hospital, Milan, Italy

Elena Cantone

Department of Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat, “Federico II” University, Naples, Italy

Giancarlo Ottaviano

Department of Neuroscience DNS, Otolaryngology Section, University of Padua, Padua, Italy

Stefania Gallo

Otorhinolaryngology Unit, Head and Neck Department, ASST Sette Laghi and UPLOAD Research Center, University of Insubria, Varese, Italy

Matteo Trimarchi

Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

Sara Torretta

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Carlo Cavaliere

Dipartimento di scienze odontostomatologiche e maxillo facciali, Sapienza University of Rome, Rome, Italy;

Daniela Lucidi

Department of Otolaryngology – Head and Neck Surgery, University Hospital of Modena, Modena, Italy

Veronica Seccia

Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Pisa, Italy

Stefano Settimi

Catholic University of The Sacred Heart, Rome, Italy

Frank Rikki Mauritz Canevari

UOC di Otorinolaringoiatria IRCCS Policlinico San Martino Genova, Dipartimento DISC Università di Genova, Genoa, Italy

Ernesto Pasquini

ENT Unit “Bellaria” Hospital – Specialized Dep AUSL Bologna, Italy

Ignazio La Mantia

ENT Unit Department “G.F. Ingrassia” – Catania University, Italy

Massimiliano Garzaro

ENT Division, Maggiore Hospital, Eastern Piedmont University, Novara, Italy

Gianluca Bellocchi

ENT Department, San Camillo‑Forlanini Hospital, Rome, Italy

Michele De Benedetto

ENT Unit, Vito Fazzi Hospital, ASL Lecce, Italy

Nicola Lombardo

ENT Unit Department of Medical and Surgical Sciences, University Magna Græcia Catanzaro, Italy

Alberto Macchi

ENT University of Insubria, ASST Settelaghi, Varese, Italy

Luca Malvezzi

IRCCS Humanitas Research Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Rozzano (MI), Italy

Gaetano Motta

Otorhinolaryngology – Head and Neck Surgery, University of Campania “L. Vanvitelli”, Naples, Italy

Claudio Vicini

Department of Head‑Neck Surgery, Otolaryngology, Head‑Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy

Alessandro Maselli

Department Otorhinolaryngology, Hospital of Barletta, Barletta (BT), Italy

Valeria Dell'Era

ENT Division, Maggiore Hospital, Eastern Piedmont University – Novara, Italy

Alberto Dragonetti

Department of Otolaryngology, Ospedale Niguarda, Milan, Italy

Francesco Asprea

Otorinolaringoiatria e audiologia, Università degli studi di Messina, Messina, Italy

Valentina Lupato

Division of Otolaryngology, Ospedale Civile di Pordenone, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy

Angelo Ghidini

Otorinolaringoiatria Azienda USL di Reggio Emilia/IRCCS, Italy

Simonetta Masieri

Dipartimento di scienze odontostomatologiche e maxillo facciali, Sapienza University of Rome, Rome, Italy

Davide Mattavelli

Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia – University of Brescia, Brescia, Italy

Francesco Antonio Salzano

Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy

Desiderio Passali

IFOS Former President and Executive Board member, Rome, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.

Jacopo Galli

Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy; Catholic University of The Sacred Heart, Rome, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.

Fabio Pagella

Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy; Otorhinolaryngology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; D. Passali, J. Galli and F. Pagella shared the seniorship of the article.

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2023

  • Abstract viewed - 90 times
  • PDF downloaded - 69 times
  • Supplementary file downloaded - 5 times