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BSACI guidelines for the management of rhinosinusitis and nasal polyposis.

机译：BSACI鼻-鼻窦炎和鼻息肉的治疗指南。

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This guidance for the management of patients with rhinosinusitis and nasal polyposis has been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). The recommendations are based on evidence and expert opinion and are evidence graded. These guidelines are for the benefit of both adult physicians and paediatricians treating allergic conditions. Rhinosinusitis implies inflammation of the nose and sinuses which may or may not have an infective component and includes nasal polyposis. Acute rhinosinusitis lasts up to 12 weeks and resolves completely. Chronic rhinosinusitis persists over 12 weeks and may involve acute exacerbations. Rhinosinusitis is common, affecting around 15% of the population and causes significant reduction in quality of life. The diagnosis is based largely on symptoms with confirmation by nasendoscopy. Computerized tomography scans and magnetic resonance imaging are abnormal in approximately one third of the population so are not recommended for routine diagnosis but should be reserved for those with acute complications, diagnostic uncertainty or failed medical therapy. Underlying conditions such as immune deficiency, Wegener's granulomatosis, Churg-Strauss syndrome, aspirin hypersensitivity and allergic fungal sinusitis may present as rhinosinusitis. There are few good quality trials in this area but the available evidence suggests that treatment is primarily medical, involving douching, corticosteroids, antibiotics, anti-leukotrienes, and anti-histamines. Endoscopic sinus surgery should be considered for complications, anatomical variations causing local obstruction, allergic fungal disease or patients who remain very symptomatic despite medical treatment. Further well conducted trials in clearly defined patient groups are needed to improve management.
机译：该治疗鼻-鼻窦炎和鼻息肉的指南是由英国过敏和临床免疫学会（BSACI）的护理标准委员会（SOCC）制定的。这些建议基于证据和专家意见，并按证据分级。这些准则对治疗过敏性疾病的成年医师和儿科医生都是有益的。鼻-鼻窦炎暗示鼻子和鼻窦发炎，可能有或没有传染成分，包括鼻息肉。急性鼻-鼻窦炎可持续长达12周并完全消退。慢性鼻-鼻窦炎持续超过12周，可能涉及急性加重期。鼻-鼻窦炎很常见，影响约15％的人口，并导致生活质量显着下降。诊断主要基于经鼻内窥镜检查确认的症状。计算机断层扫描和磁共振成像在大约三分之一的人群中是异常的，因此不建议用于常规诊断，而应保留给那些患有急性并发症，诊断不确定或药物治疗失败的患者。潜在的疾病包括免疫缺陷，韦格纳肉芽肿病，Churg-Strauss综合征，阿司匹林超敏反应和过敏性真菌性鼻窦炎。在这一领域，几乎没有高质量的试验，但是现有证据表明，治疗主要是药物治疗，涉及冲洗，皮质类固醇，抗生素，抗白三烯和抗组胺药。应考虑内窥镜鼻窦手术的并发症，导致局部梗阻的解剖学差异，过敏性真菌病或尽管接受药物治疗但仍非常有症状的患者。需要在明确定义的患者组中进行进一步的良好试验，以改善管理。

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