The updated Clinical Practice Guideline published in the August issue of Otolaryngology–Head and Neck Surgery, providing the first comprehensive revision since 2015.
The American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) has published an updated clinical practice guideline for adult sinusitis that revises and expands upon the prior guideline, last updated in 2015. This updated guideline provides clinicians with trustworthy, evidence-based recommendations on the care of adults with sinusitis.
"With sinusitis affecting about one in eight adults in the United States each year, this CPG update empowers both patients and their healthcare providers with evidence-based recommendations that can lead to better outcomes,” said Spencer C. Payne, MD, Chair of the Guideline Update Group.
Goals of the Guideline Update
The updated guideline aims to improve diagnostic accuracy for adult rhinosinusitis, promote judicious use of systemic and topical therapy, and promote the appropriate use of ancillary tests to confirm diagnosis and guide management, including radiography, nasal endoscopy, computed tomography, and testing for allergy and immune function.
Sinusitis By the Numbers
Sinusitis affects approximately one in eight adults in the United States, resulting in more than 30 million annual diagnoses. The direct cost of managing acute and chronic sinusitis exceeds $11 billion per year. More than one in five antibiotics prescribed to adults are for sinusitis, making it the fifth-most common diagnosis responsible for antibiotic therapy.
What's New
The updated guideline incorporates new evidence from 14 guidelines, 194 systematic reviews, and 133 randomized controlled trials published.
Shared Dr. Payne, “Key changes from the 2015 guideline include expanding ‘watchful waiting’ as the preferred initial approach for most bacterial sinus infections, since most people get better on their own. We've also provided clearer guidance on when antibiotics are truly needed, what the first-choice antibiotic should be, and new information about advanced treatments like biologics for chronic sinusitis with nasal polyps. Most importantly, we've emphasized that not all sinus symptoms require antibiotics, and there are effective symptomatic treatments like nasal saline rinses and steroid sprays that can provide relief. We encourage patients to have open conversations with their healthcare providers about these options to find the right treatment approach for their specific situation."
To support implementation, the guideline includes a new, comprehensive algorithm, expanded action statement profiles, and a plain language summary for patients and families. The full KASs and the guideline with other supplemental materials can be found on the Academy’s website athttp://www.entnet.org/CPG.
CPG Resources Available Now
Clinical Practice Guideline
Executive Summary
Plain Language Summary
Key Action Statement Summary and Flowchart
Patient Handout: FAQs about the Surgical Management of CRS (English and Spanish versions available)
Handout: Agreement on Expectations of Sinus Surgery
Handout: Postoperative Instructions and Questions
Future Research Needs
Guideline Central: CPG Pocket Guide, App, and Flipbook
Coming Soon
Podcast: Implications for Otolaryngologists
Podcast: Implications for Non-otolaryngologists
Authors and Endorsing Societies
The guideline development group included specialists representing the disciplines of otolaryngology-head and neck surgery, infectious disease, family medicine, allergy and immunology, advanced practice nursing, and a consumer advocate.
The CPG authors are: Spencer C. Payne, MD (chair), Margo McKenna (methodologist), MD, Jennifer Buckley, MD, Maria Colandrea, DNP, NP-C, Anthony Chow, MD, Kara Detwiller, MD, Angela Donaldson, MD, Marc Dubin, MD, Sandra Finestone, MA, PsyD, Peter Filip, MD, Ayesha Khalid, MD, MBA, Anju T. Peters, MD, Richard Rosenfeld, MD, MPH, MBA, Zarah Akrami, MPH (AAO-HNSF staff), and Nui Dhepyasuwan, MEd (AAO-HNSF staff).
The CPG for Adult Sinusitis Update is endorsed by:
American Academy of Allergy, Asthma & Immunology (AAAI)
American Academy of Otolaryngic Allergy (AAOA)
American Rhinologic Society (ARS)
Society of Otorhinolaryngology and Head-Neck Nurses (SOHN)
