Evaluation of ESS effectiveness in improving quality of life. This includes an evidence-based regimen for appropriate medical therapy to pursue before considering surgery, said Dr. Orlandi, as well as intraoperative technique, and pre- and postoperative care.
Explore this issue:May 2016
Dr. Orlandi hopes that the statement’s publication will spur more questions and higher-level research. “We hope to better understand the heterogeneity within CRS,” he said. “Previously, it was thought of as either one or two conditions, but there are far more than that. When we better define the different disease states, we can then understand the more than a dozen treatments we’ve examined.”
An enhanced understanding of how different treatments work on the various RS subtypes would also help better target individual medical therapy. “Where one treatment might not work well overall, it might have great effect in a subtype,” said Dr. Orlandi. “We’ve all seen that in our practices—there will be one patient who will respond to a particular treatment when most don’t. We need to better define what treatments work best for which subtypes. It’s analogous to targeting particular cancer cells with specific chemotherapy types.”
Dr. Tabaee believes that this statement will help clinician scientists have a common dialogue about the missing areas of information ripe for scientific research. “Interestingly, the statement raises as many questions as it answers,” he says. “There are areas of recently identified pathophysiology including biofilms and genetic predisposition that do not have a clear pathway in diagnosis or treatment in the clinical work place. Further, identifying which patients will likely benefit from surgery earlier rather than later in the disease course is still a work in progress. This research statement creates a common platform for translating the current literature to clinical care considerations that are supported by scientific evidence and equally importantly highlights fundamental aspects of CRS that require further investigation.”
Amy E. Hamaker is a freelance medical writer based in California.