International consensus statement on allergy and rhinology: rhinosinusitis 2021

Richard R Orlandi¹, Todd T Kingdom², Timothy L Smith³, Benjamin Bleier⁴, Adam DeConde⁵, Amber U Luong⁶, David M Poetker⁷, Zachary Soler⁸, Kevin C Welch⁹, Sarah K Wise¹⁰, Nithin Adappa¹¹, Jeremiah A Alt¹, Wilma Terezinha Anselmo-Lima¹², Claus Bachert^{13

14

15}, Fuad M Baroody¹⁶, Pete S Batra¹⁷, Manuel Bernal-Sprekelsen¹⁸, Daniel Beswick¹⁹, Neil Bhattacharyya⁴, Rakesh K Chandra²⁰, Eugene H Chang²¹, Alexander Chiu²², Naweed Chowdhury²³, Martin J Citardi⁶, Noam A Cohen¹¹, David B Conley²⁴, John DelGaudio¹⁰, Martin Desrosiers²⁵, Richard Douglas²⁶, Jean Anderson Eloy²⁷, Wytske J Fokkens²⁸, Stacey T Gray⁴, David A Gudis²⁹, Daniel L Hamilos³⁰, Joseph K Han³¹, Richard Harvey³², Peter Hellings³³, Eric H Holbrook⁴, Claire Hopkins³⁴, Peter Hwang³⁵, Amin R Javer³⁶, Rong-San Jiang³⁷, David Kennedy¹¹, Robert Kern²⁴, Tanya Laidlaw⁴, Devyani Lal³⁸, Andrew Lane³⁹, Heung-Man Lee⁴⁰, Jivianne T Lee¹⁹, Joshua M Levy¹⁰, Sandra Y Lin³⁹, Valerie Lund⁴¹, Kevin C McMains⁴², Ralph Metson⁴, Joaquim Mullol⁴³, Robert Naclerio³⁹, Gretchen Oakley¹, Nobuyoshi Otori⁴⁴, James N Palmer¹¹, Sanjay R Parikh⁴⁵, Desiderio Passali⁴⁶, Zara Patel³⁵, Anju Peters²⁴, Carl Philpott⁴⁷, Alkis J Psaltis⁴⁸, Vijay R Ramakrishnan², Murugappan Ramanathan Jr³⁹, Hwan-Jung Roh⁴⁹, Luke Rudmik⁵⁰, Raymond Sacks⁵¹, Rodney J Schlosser⁸, Ahmad R Sedaghat⁵², Brent A Senior⁵³, Raj Sindwani⁵⁴, Kristine Smith⁵⁵, Kornkiat Snidvongs⁵⁶, Michael Stewart⁵⁷, Jeffrey D Suh¹⁹, Bruce K Tan²⁴, Justin H Turner²³, Cornelis M van Drunen⁵⁸, Richard Voegels⁵⁹, De Yun Wang⁶⁰, Bradford A Woodworth⁶¹, Peter-John Wormald⁴⁸, Erin D Wright⁶², Carol Yan⁶³, Luo Zhang⁶⁴, Bing Zhou⁶⁴

Affiliations

¹ University of Utah, Salt Lake City, UT.
² University of Colorado, Denver, CO.
³ Oregon Health Science University, Portland, OR.
⁴ Harvard Medical School, Boston, MA.
⁵ UC San Diego, San Diego, CA.
⁶ University of Texas Medical School at Houston, Houston, TX.
⁷ Medical College of Wisconsin, Milwaukee, WI.
⁸ Medical University of South Carolina, Charleston, SC.
⁹ Feinberg School of Medicine, Northwestern University, Chicago, IL.
¹⁰ Emory University, Atlanta, GA.
¹¹ University of Pennsylvania, Philadelphia, PA.
¹² Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
¹³ Ghent University, Ghent, Belgium.
¹⁴ Karolinska Institute, Stockholm, Sweden.
¹⁵ Sun Yatsen University, Gangzhou, China.
¹⁶ University of Chicago, Chicago, IL.
¹⁷ Rush University Medical Center, Chicago, IL.
¹⁸ Hospital Clinic, University of Barcelona, Spain.
¹⁹ UCLA Medical Center, Los Angeles, CA.
²⁰ Vanderbilt University, Nashville, TN.
²¹ University of Arizona, Tucson, AZ.
²² University of Kansas Medical Center, Kansas City, KS.
²³ Vanderbilt University Medical Center, Nashville, TN.
²⁴ Northwestern University, Chicago, IL.
²⁵ Université de Montréal, Montreal, Quebec, Canada.
²⁶ University of Auckland, Auckland, New Zealand.
²⁷ Rutgers New Jersey Medical School, Newark, NJ.
²⁸ University of Amsterdam, Amsterdam, Netherlands.
²⁹ Columbia University Irving Medical Center, New York, NY.
³⁰ Massachusetts General Hospital, Harvard Medical School, Boston, MA.
³¹ Eastern Virginia Medical School, Norfolk, VA.
³² University of New South Wales and Macquarie University, Sydney, New South Wales, Australia.
³³ University Hospitals Leuven, Leuven, Belgium.
³⁴ Guy's Hospital, London, UK.
³⁵ Stanford University, Stanford, CA.
³⁶ University of British Columbia, Vancouver, British Columbia, Canada.
³⁷ Taichung Veterans General Hospital, Taichung, Taiwan.
³⁸ Mayo Clinic in Arizona, Phoenix, AZ.
³⁹ Johns Hopkins University, Baltimore, MD.
⁴⁰ Korea University, Seoul, Korea.
⁴¹ Royal National Throat Nose and Ear Hospital, UCLH, London, UK.
⁴² Uniformed Services University of Health Sciences, San Antonio, TX.
⁴³ IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain.
⁴⁴ Jikei University, Tokyo, Tokyo, Japan.
⁴⁵ University of Washington, Seattle, WA.
⁴⁶ University of Siena, Rome, Italy.
⁴⁷ University of East Anglia, Norwich, Norfolk.
⁴⁸ University of Adelaide, Adelaide, South Australia, Australia.
⁴⁹ Pusan National University, Yangsan, Korea.
⁵⁰ University of Calgary, Calgary, Alberta, Canada.
⁵¹ University of New South Wales, Sydney, New South Wales, Australia.
⁵² University of Cincinnati College of Medicine, Cincinnati, OH.
⁵³ University of North Carolina, Chapel Hill, NC.
⁵⁴ Cleveland Clinic Foundation, Cleveland, OH.
⁵⁵ University of Winnipeg, Winnipeg, Manitoba, Canada.
⁵⁶ Chulalongkorn University, Bangkok, Thailand.
⁵⁷ Weill Cornell Medical College, New York, NY.
⁵⁸ Amsterdam University Medical Centers, Amsterdam, Netherlands.
⁵⁹ Universidade de São Paulo, São Paulo, Brazil.
⁶⁰ National University of Singapore, Singapore, Singapore.
⁶¹ University of Alabama at Birmingham, Birmingham, AL.
⁶² University of Alberta, Edmonton, Alberta, Canada.
⁶³ University of California San Diego, La Jolla, CA.
⁶⁴ Capital Medical University, Beijing, China.

PMID: 33236525
DOI: 10.1002/alr.22741

Review

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Richard R Orlandi et al. Int Forum Allergy Rhinol. 2021 Mar.

. 2021 Mar;11(3):213-739.

doi: 10.1002/alr.22741.

Authors

Affiliations

¹ University of Utah, Salt Lake City, UT.
² University of Colorado, Denver, CO.
³ Oregon Health Science University, Portland, OR.
⁴ Harvard Medical School, Boston, MA.
⁵ UC San Diego, San Diego, CA.
⁶ University of Texas Medical School at Houston, Houston, TX.
⁷ Medical College of Wisconsin, Milwaukee, WI.
⁸ Medical University of South Carolina, Charleston, SC.
⁹ Feinberg School of Medicine, Northwestern University, Chicago, IL.
¹⁰ Emory University, Atlanta, GA.
¹¹ University of Pennsylvania, Philadelphia, PA.
¹² Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
¹³ Ghent University, Ghent, Belgium.
¹⁴ Karolinska Institute, Stockholm, Sweden.
¹⁵ Sun Yatsen University, Gangzhou, China.
¹⁶ University of Chicago, Chicago, IL.
¹⁷ Rush University Medical Center, Chicago, IL.
¹⁸ Hospital Clinic, University of Barcelona, Spain.
¹⁹ UCLA Medical Center, Los Angeles, CA.
²⁰ Vanderbilt University, Nashville, TN.
²¹ University of Arizona, Tucson, AZ.
²² University of Kansas Medical Center, Kansas City, KS.
²³ Vanderbilt University Medical Center, Nashville, TN.
²⁴ Northwestern University, Chicago, IL.
²⁵ Université de Montréal, Montreal, Quebec, Canada.
²⁶ University of Auckland, Auckland, New Zealand.
²⁷ Rutgers New Jersey Medical School, Newark, NJ.
²⁸ University of Amsterdam, Amsterdam, Netherlands.
²⁹ Columbia University Irving Medical Center, New York, NY.
³⁰ Massachusetts General Hospital, Harvard Medical School, Boston, MA.
³¹ Eastern Virginia Medical School, Norfolk, VA.
³² University of New South Wales and Macquarie University, Sydney, New South Wales, Australia.
³³ University Hospitals Leuven, Leuven, Belgium.
³⁴ Guy's Hospital, London, UK.
³⁵ Stanford University, Stanford, CA.
³⁶ University of British Columbia, Vancouver, British Columbia, Canada.
³⁷ Taichung Veterans General Hospital, Taichung, Taiwan.
³⁸ Mayo Clinic in Arizona, Phoenix, AZ.
³⁹ Johns Hopkins University, Baltimore, MD.
⁴⁰ Korea University, Seoul, Korea.
⁴¹ Royal National Throat Nose and Ear Hospital, UCLH, London, UK.
⁴² Uniformed Services University of Health Sciences, San Antonio, TX.
⁴³ IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain.
⁴⁴ Jikei University, Tokyo, Tokyo, Japan.
⁴⁵ University of Washington, Seattle, WA.
⁴⁶ University of Siena, Rome, Italy.
⁴⁷ University of East Anglia, Norwich, Norfolk.
⁴⁸ University of Adelaide, Adelaide, South Australia, Australia.
⁴⁹ Pusan National University, Yangsan, Korea.
⁵⁰ University of Calgary, Calgary, Alberta, Canada.
⁵¹ University of New South Wales, Sydney, New South Wales, Australia.
⁵² University of Cincinnati College of Medicine, Cincinnati, OH.
⁵³ University of North Carolina, Chapel Hill, NC.
⁵⁴ Cleveland Clinic Foundation, Cleveland, OH.
⁵⁵ University of Winnipeg, Winnipeg, Manitoba, Canada.
⁵⁶ Chulalongkorn University, Bangkok, Thailand.
⁵⁷ Weill Cornell Medical College, New York, NY.
⁵⁸ Amsterdam University Medical Centers, Amsterdam, Netherlands.
⁵⁹ Universidade de São Paulo, São Paulo, Brazil.
⁶⁰ National University of Singapore, Singapore, Singapore.
⁶¹ University of Alabama at Birmingham, Birmingham, AL.
⁶² University of Alberta, Edmonton, Alberta, Canada.
⁶³ University of California San Diego, La Jolla, CA.
⁶⁴ Capital Medical University, Beijing, China.

PMID: 33236525
DOI: 10.1002/alr.22741

Erratum in

Corrigendum.
[No authors listed] [No authors listed] Int Forum Allergy Rhinol. 2022 Jul;12(7):974. doi: 10.1002/alr.22987. Epub 2022 Mar 11. Int Forum Allergy Rhinol. 2022. PMID: 35274477 No abstract available.

Abstract

Executive summary: BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document.

Methods: ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary.

Results: ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided.

Conclusion: This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.

Keywords: acute rhinosinusitis; chronic rhinosinusitis; endoscopic sinus surgery; evidence-based medicine; recurrent acute rhinosinusitis; rhinosinusitis; systematic review.

PubMed Disclaimer

Comment in

EDS-FLU: An important step in appropriate medical therapy for chronic rhinosinusitis with nasal polyps.
Leopold DA, Elkayam D, Han JK, Soteres DF, Messina JC, Carothers JL, Sacks HJ, Mahmoud RA, Djupesland PG, Sindwani R. Leopold DA, et al. Int Forum Allergy Rhinol. 2022 Jun;12(6):893-895. doi: 10.1002/alr.22998. Epub 2022 Apr 17. Int Forum Allergy Rhinol. 2022. PMID: 35348302 No abstract available.
Reply to "EDS-FLU: An important step in appropriate medical therapy for chronic rhinosinusitis with nasal polyps".
Orlandi R. Orlandi R. Int Forum Allergy Rhinol. 2022 Jun;12(6):896-897. doi: 10.1002/alr.22999. Epub 2022 Apr 17. Int Forum Allergy Rhinol. 2022. PMID: 35353956 No abstract available.

References

REFERENCES

1. Orlandi RR, Kingdom TT, Hwang PH, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(Suppl 1):S22-S209.
1. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382(12):1177-1179.
1. Yan C, Faraji F, Prajapati D, Boone C, DeConde A. Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol. 10(7):806-813
1. Rudmik L, Smith TL. Development of an evidence-based review with recommendations using an online iterative process. Int Forum Allergy Rhinol. 2011;1(6):431-437.
1. Brozek JL, Akl EA, Alonso-Coello P, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64(5):669-677.

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International consensus statement on allergy and rhinology: rhinosinusitis 2021

Affiliations

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Authors

Affiliations

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