Research Needs section from Surgical Management of Chronic Rhinosinusitis CPG
- How do symptoms and QOL scores correlate to objective findings in adult CRS patients?
- Are certain QOL components predictive of greater improvement after sinus surgery?
- Scoping review of the diagnostic criteria for CRS from all the international papers — differences, consistencies and best practices among the different diagnostic criteria.
- Which findings (exam, symptoms) are most predictive of paranasal sinus disease/CRS and should initiate an otolaryngology referral?
- Establish a better disease profile for CRS. What patient criteria (e.g. gender/sex, age, subjective and objective findings) are most likely to lead to good surgery outcomes?
- What characteristics of polyp disease show the least benefit from medical therapy?
- Better define which CRS disease subtypes benefit least from certain medical treatments.
- Can we establish definitions of limited surgery vs. complete surgery or a scale to better classify the type of surgery performed?
- What is the proper extent of surgery in CRS patients with nasal polyps?
- Longitudinal studies to look at effects of different therapies (medical and surgical) over time. What sinonasal diseases or symptoms can be cured vs. controlled?
- When does surgery fall in an overall care plan that includes biological medications?
- Should biologicals be trialed prior to surgery?
- Should biologicals be stopped for surgery? Should they be started at a certain timeframe before or after surgery?
- Does the extent of surgery change in a patient using biologicals?
- What is a patient’s understanding preoperatively and how is this related to patient satisfaction postoperatively? Does this vary based on patient demographics and CRS disease subtype? Do different educational methods determine retention of information of CRS treatment plan and surgical risks and expectations?
- What modes of education promote the highest level of compliance with or adherence to the entire treatment plan?
- What are the patient’s priorities when considering ESS for CRS?
- What are the effects of macrolide antibiotics for CRS treatment and what is the recommended treatment length and what is the risk profile? In patients undergoing limited ESS on certain sinuses, what happens in the non-diseased sinuses? Are rates of revision or continued symptoms higher?
- How do measurements of mucosal inflammation correlate to symptoms and surgical outcomes?
- What is the expected pain level after ESS and how is pain best controlled?
- Which instruments (either patient report or endoscopic) have the best predictive value for longer term outcomes?
- Which metrics in short term follow up are more likely to predict disease control long term?
- How does compliance with the care plan relate to overall disease control (short, intermittent and long term compliance)?
- What is the ideal postoperative and long term care plan?
- What is the best protocol for debridement (e.g both the timing of debridement as well as the extent)? What is the ideal frequency of post operative visits and long term follow up? When does mucociliary clearance return to normal after surgery and does this differ based on CRS subtype?
