Current diagnostic and therapeutic management of chronic rhinosinusitis with nasal polyps in Austria: insights and unmet needs from a nationwide survey

TL;DR

This study explores how Austrian ENT specialists diagnose and treat chronic rhinosinusitis with nasal polyps, identifying areas needing improvement.

Contribution

A nationwide survey in Austria reveals current practices and unmet needs in CRSwNP management, emphasizing gaps in biologic treatment and guideline adherence.

Findings

Local corticosteroids are most frequently prescribed, while systemic corticosteroids are overused.

Hospital-based physicians manage more patients with biologics, but adoption of biologics remains limited.

Adherence to guidelines for biologic treatment response is suboptimal, indicating a need for improved clinical practices.

Abstract

This article aims to describe the current diagnostic and therapeutic practices for managing chronic rhinosinusitis with nasal polyps (CRSwNP) among Austrian ENT specialists. A cross-sectional, nationwide survey was conducted between November and December 2022 in Austria. A total of 50 ENT specialists, evenly split between hospital- and office-based physicians, participated. The questionnaire covered demographics, diagnostic and therapeutic approaches. CT imaging, nasal endoscopy, and blood eosinophil count were the most utilized diagnostic tools. Most participants applied the SNOT-22 for patient-reported outcomes. Local corticosteroids were the most frequently prescribed treatment. Systemic corticosteroid overuse and limited biologic adoption were noted. Hospital-based physicians managed significantly more patients with biologics. The initiation of biologic therapy was considered most appropriate following one FESS by the vast majority of respondents. Adherence to guideline-based evaluation criteria for biologic treatment response was suboptimal, highlighting gaps in clinical practice. Our survey highlights strengths in guideline adherence and areas for improvement, particularly in the diagnostic approach, systemic corticosteroid usage, and biologic treatment. Addressing educational gaps and refining clinical practices could enhance patient outcomes, reduce invasive procedures, and optimize resource utilization in CRSwNP management.

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