Asia-Pacific survey of physicians’ perceptions and managements of chronic rhinosinusitis

Background: The diagnosis and management of patients with chronic rhinosinusitis (CRS) may vary between otolaryngologists and allergists. Moreover, the adherence of different practitioners to European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS)2020 guideline recommendations has not been previously ascertained in Asia-Pacific regions. Objective: Different specialists’ perceptions and managements of CRS in Asia-Pacific regions were assessed in an attempt to gauge these practices against EPOS2020 guidelines. Methods: A transregional, cross-sectional survey was conducted to assess otolaryngologists’ and allergists’ perceptions and managements of CRS with regard to diagnosis, management and adherence to EPOS2020 guidelines. Results: Sixteen physicians in Asia-Pacific regions responded to the questionnaire. A total of 71.4% of otolaryngologists preferred to diagnose CRS with a combination of positive nasal symptoms and nasal endoscopy plus sinus CT, whereas 22.2% of allergists took such criterion to diagnose CRS. Compared to allergists, otolaryngologists more often considered the endotype classification (85.8% versus 55.5%). For the preferred first-line treatment, in addition to intranasal corticosteroids recommended by all respondents, 66.7% of allergists preferred antihistamines, whereas 71.4% of otolaryngologists preferred nasal saline irrigation. Regarding the proper timing of surgery, 71.4% of otolaryngologists reported 8-12 weeks of treatment after the initiation of medication, while more than half of the allergists recommended 4-6 weeks of medical treatment. Conclusion: This survey shows that variable perceptions and practices for CRS may exist between physicians with different specialties and highlights the need for increased communication and awareness between otolaryngologists and allergists to improve the diagnosis and treatment of CRS.