Friday, October 5, 2012

EP3OS: review of 2007

The EP3OS guidelines offer a series of basic recommendations for the diagnosis and treatment of both chronic and acute rhinosinusitis and nasal polyposis.

These diseases have a high prevalence in the Western world. In the United States, it is calculated that up to 14% of the population (about 40 million people) suffer from this chronic disease and, more importantly, its prevalence continues to increase. However, it is also a disorder associated with a high economic cost. Its impact on the quality of life is not insignificant either, as it has an adverse effect on the performance of daily tasks.
Europe currently suffers from a marked lack of epidemiological studies, which prevents a more realistic approach being taken to this problem. From the studies that have been performed, it is inferred that the milder forms of rhinosinusitis, such as the common cold, affect up to 100% of the European population, with an average of two infections a year per affected person. It is estimated that the prevalence of acute rhinosinusitis in the EU countries is 1-2%, while that of chronic rhinosinusitis is 10%.


 Rhinosinusitis has a negative effect on the patient’s quality of life and, to a certain extent, on that of his family. Recent studies not only show that patients with chronic rhinosinusitis have a significantly worse quality of life (measured with the SF-36 test) than the general population, but also that their quality of life is below that of patients with high blood pressure, diabetes or even angina pectoris.
In 2005, Fokkens et al. (Rhinology 2005, suppl 18: 1-88; Allergy 2005, 60: 583-601, executive summary) published the EP3OS guidelines (European Position Paper on Nasal Polyposis and Rhinosinusitis). The medium/long-term goal was to combine this document with the GINA guidelines (for asthma) and the ARIA recommendations (for rhinitis) in a single guideline, endorsed by the World Health Organisation.

The first EP3OS consensus has been reviewed with the goal of correcting errors and consolidating certain basic ideas in the management of rhinosinusitis and nasal polyposis. With more than 120 pages, the new document will be translated into more than 30 languages. “The need to perform a review after so little time is basically because of the significant number of studies that have been performed on rhinosinusitis in recent years, which have led to substantial changes in the evidence available on the best treatments,” acknowledged Dr. Mullol.
The EP3OS 2007 guidelines pursue many goals: review the knowledge available on rhinosinusitis and nasal polyposis; update diagnostic methods on the basis of recent evidence; revise available treatments applying documented evidence; refine the treatment approach to the disease; and guide the definitions and diagnostic methods used in research.

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