Rhinosinusitis: Evidence and experience – 2024

• Prolonged Acute Viral Rhinosinusitis is a cold lasting more than 7–10 days, with slow and progressive improvement, reinforcing its typically viral origin. • Antibiotics should be used only in severe, unequivocally diagnosed ABRS. For moderated cases, the “watchful waiting/delayed prescription”, is recommended. • Suspicion of orbital complication should be investigated with contrast CT and hospitalization under intravenous antibiotic therapy. Consider surgery. • Surgery plays a very important role in the management of CRS. Either curative or providing control of the disease combined with medical treatment. • Biologics are a good treatment option for some patients with severe CRSwNP refractory to standard treatment. It has been 10-years since the publication of Rhinosinusitis: evidence and experience, and since then a lot has changed in our understanding of the disease. Advances in pathophysiology, endotyping and new treatments such as biologics brought a new era in the management of our patients. This new guideline, developed jointly by ABR and ABORL-CCF, with the help of ASBAI presents an updated, evidence-based approach to the different forms of rhinosinusitis that aims to improve the diagnosis and treatment of this complex disease. The document covers a wide range of topics, including clear definitions of the different stages of acute sinusitis. It also introduces a new term called Prolonged Acute Viral Rhinosinusitis. Reviews phenotypes and endotypes of chronic rhinosinusitis, recommending methods for clinical and laboratory investigation, clinical and surgical treatment. We also discuss in detail fungal sinusitis and pediatric sinusitis. The objective of this updated Consensus is to clarify some already established and recent concepts, highlighting the importance of an accurate diagnosis to promote treatment approaches that reflect the best practices based on solid evidence. Therefore, we seek not only to improve the results of patients care, but also to guide thealth professionals through a clinical panorama that is in constant transformation.