Author(s)
Jiahui Lin, MD
Ashutosh Kacker, MD
Affiliation(s)
Weill Cornell Medical College
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand that management of patients with recurrent acute rhinosinusitis (RARS) is often challenging and robust data in the literature is scant. They should be able to explain the current treatment strategies for RARS used by otolaryngologists. Objectives: Management of patients with recurrent acute rhinosinusitis (RARS) is often challenging and robust data in the literature is scant. The aim of this study is to better characterize the current treatment strategies for RARS used by otolaryngologists. Study Design: Cross-sectional survey study. Methods: An online survey sent to all members of the American Rhinologic Society in May 2015 evaluated demographics, practice characteristics, and management strategies for patients with RARS, subdivided into those with (RARSwD) and without (RARSsD) septal deviation. Results: Ninety-four members responded of whom 38% were fellowship trained rhinologists. For most cases of RARSsD, 61% of otolaryngologists would primarily use medical management. Most would wait until patients had experienced 4 to 5 episodes to perform balloon sinuplasty (80%) or surgery (78%). The surgical procedure of choice was limited sinus surgery (62%). For RARSwD 51% primarily used medical management. Eighty-eight percent of private practitioners would wait to perform balloon sinuplasty until patients had experienced 4 to 5 episodes. Only 68% of those in academia would wait for the same amount of time, and 22% would perform balloon sinuplasty after only 1 to 3 episodes (P=0.05). Nearly all fellowship trained rhinologists (97%) would perform limited sinus surgery with septoplasty for RARSwD, while 24% of other otolaryngologists would perform complete sinus surgery with septoplasty (P=0.05). Conclusions: Treatment of patients with RARS is complex, and the differences in strategies employed between groups of otolaryngologists may reflect their training backgrounds and different patient populations, as well as a need for further research to establish more definitive guidelines for management.