Controversies in Medical and Surgical Management of Chronic Rhinosinusitis with Nasal Polyps:What Is the Evidence?

PROGRAM DESCRIPTION: Although recent years have witnessed significant expansion and innovation in our treatment armamentarium for chronic rhinosinusitis with nasal polyposis (CRSwNP), optimal application of available therapeutic options remains a subject of ongoing debate. The purpose of this panel presentation is to discuss current controversies in medical and surgical management of CRSwNP, with a focus on recently introduced therapies and the relevant evidence. Emerging systemic immunomodulators and their clinical efficacy for various CRSwNP endotypes will be delineated. Controversial aspects of biologic therapy will be addressed; including indications, selection, timing, and tapering with a review of the pertinent literature. In addition, the role of topical anti-inflammatory agents and long-term macrolide therapy in CRSwNP will be discussed. Current formulations, protocols, risks, benefits, and arguments for and against such treatments will be elucidated along with the corresponding evidence. Furthermore, novel “big hole” endoscopic surgical approaches for management of CRSwNP will be presented. The indications, techniques, and controversies involved with such revision surgical salvage procedures will be described in conjunction with video presentations. This session will be conducted by academic rhinologists using a multimedia, interactive case-based format with audience polling.

OUTCOME OBJECTIVE 1: Recognize the evolving role of systemic biologics, emerging immunomodulators, topical anti-inflammatory agents, and long-term macrolides in treatment of chronic rhinosinusitis with nasal polyposis

OUTCOME OBJECTIVE 2: Describe novel “big hole” revision endoscopic surgical procedures for management of refractory chronic rhinosinusitis with nasal polyposis; including indications, techniques, and controversial aspects

OUTCOME OBJECTIVE 3: Understand the current evidence, clinical efficacy, and optimal application of each therapeutic modality in patients with chronic rhinosinusitis with nasal polyposis

BACKGROUND STATEMENT: Need to understand the controversial aspects, advantages/disadvantages, and relevant evidence of newly introduced medical and surgical treatment options for chronic rhinosinusitis with nasal polyposis, which continues to remain a challenge for many otolaryngologists to manage.

Comprehensive Otolaryngology Track Statement : Not applicable.