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

Eur Arch Otorhinolaryngol. 2024 Jan;281(1):227-235. doi: 10.1007/s00405-023-08185-5. Epub 2023 Sep 1.

Abstract

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.

Keywords: Biological therapy; Inflammation; Nasal polyps; Nose diseases; Patient reported outcome measures; Surveys and Questionnaires.

MeSH terms

  • Chronic Disease
  • Cross-Sectional Studies
  • Humans
  • Nasal Polyps* / complications
  • Nasal Polyps* / diagnosis
  • Nasal Polyps* / surgery
  • Quality of Life
  • Rhinitis* / complications
  • Rhinitis* / diagnosis
  • Rhinitis* / surgery
  • Rhinosinusitis*
  • Sinusitis* / complications
  • Sinusitis* / diagnosis
  • Sinusitis* / therapy
  • Spain / epidemiology
  • Surveys and Questionnaires