Abstract：
Chronic rhinosinusitis (CRS) is a sino-nasal chronic inflammatory disease, occurring in 5-15% of the general population. CRS with nasal polyps (CRSwNP) is present in up to 30% of the CRS population. One-third of CRSwNP patients suffer from disease that is uncontrolled by current standards of care. Biologics are an emerging treatment option for patients with severe uncontrolled CRSwNP, but their positioning in the treatment algorithm is under discussion. Effective endotyping of CRSwNP patients who could benefit from biologics treatment is required, as suggested by international guidelines. Other issues affecting management include comorbidities, such as allergy, non-steroidal anti-inflammatory drug-exacerbated respiratory disease, and asthma. Therefore, the choice of treatment in CRSwNP patients depends on many factors. A multidisciplinary approach may improve CRSwNP management in patients with comorbidities, but currently there is no shared management model. We summarize the outcomes of a Delphi process involving a multidisciplinary panel of otolaryngologists, pulmonologists, and allergist-immunologists involved in the management of CRSwNP, who attempted to reach consensus on key statements relating to the diagnosis, endotyping, classification and management (including the place of biologics) of CRSwNP patients.
摘要：
慢性鼻-鼻窦炎(CRS)是一种鼻部慢性炎症性疾病,发生在一般人群的5-15％。伴鼻息肉的CRS(CRSwNP)存在于高达30%的CRS群体中。三分之一的CRSwNP患者患有不受当前护理标准控制的疾病。生物制剂是严重不受控制的CRSwNP患者的新兴治疗选择。但是他们在治疗算法中的定位正在讨论中。需要对可能从生物制剂治疗中受益的CRSwNP患者进行有效的内分型，正如国际准则所建议的那样。影响管理的其他问题包括合并症，比如过敏,非甾体抗炎药加剧了呼吸系统疾病，和哮喘。因此,CRSwNP患者的治疗选择取决于多种因素.多学科方法可以改善合并症患者的CRSwNP管理，但是目前没有共享的管理模式。我们总结了涉及耳鼻喉科医师多学科小组的Delphi过程的结果，肺病学家,以及参与CRSwNP管理的过敏症-免疫学家，他试图就与诊断有关的关键陈述达成共识，内分型,CRSwNP患者的分类和管理（包括生物制剂的位置）。
