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Abstract：
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic and often debilitating inflammatory condition of the nasal and paranasal tissues. An expert panel of specialists from the Gulf region (the Kingdom of Saudi Arabia, Kuwait, Oman and the United Arab Emirates) and from Egypt gathered to evaluate existing guidance and develop regional guidance on the management of CRSwNP through a consensus approach. The present article presents the main observations and recommendations from this panel. CRSwNP diagnosis requires the presence of bilateral, endoscopically visualized polyps in the middle meatus (via nasal endoscopy or CT). In most patients, CRSwNP is mediated through predominantly type 2 inflammatory processes and is often observed in patients with asthma and other allergic disease. While many patients respond to medical treatment (principally topical irrigation and intranasal corticosteroids, and adjunctive short-term use of systemic corticosteroids), clinical management of CRSwNP is challenging, and a multidisciplinary approach for complete evaluation and treatment is recommended. Patients with more severe/uncontrolled disease (despite adequate medical therapies) require a complete endoscopic sinus surgery (ESS), although outcomes can be unsatisfactory, and further revision surgery is common. Biological therapies targeting underlying inflammatory processes offer additional, effective treatment options for those patients with persistent symptoms despite complete ESS, and also in those patients where surgery may be contraindicated.
摘要：
慢性鼻窦炎伴鼻息肉（CRSwNP）是鼻和鼻旁组织的慢性且通常使人衰弱的炎症。海湾地区专家组成的专家小组(沙特阿拉伯王国，科威特,阿曼和阿拉伯联合酋长国）和埃及聚集在一起，通过共识方法评估现有指南并制定关于CRSwNP管理的区域指南。本文介绍了该小组的主要意见和建议。CRSwNP诊断需要双侧，内镜下可见中鼻道息肉（通过鼻内镜或CT）。在大多数患者中，CRSwNP主要通过2型炎症过程介导，通常在哮喘和其他过敏性疾病患者中观察到。虽然许多患者对药物治疗有反应（主要是局部冲洗和鼻内皮质类固醇，和辅助短期使用全身性皮质类固醇），CRSwNP的临床管理具有挑战性，建议采用多学科方法进行全面评估和治疗。患有更严重/不受控制的疾病的患者（尽管有足够的药物治疗）需要完整的内窥镜鼻窦手术（ESS），尽管结果可能不令人满意，进一步的翻修手术很常见。针对潜在炎症过程的生物疗法提供了额外的，尽管完全ESS，但仍有持续症状的患者的有效治疗选择，以及那些手术可能禁忌的患者。
