Criteria

Chronic rhinosinusitis in adults: definition from European position paper[2]​​

Chronic rhinosinusitis in adults is defined as the presence of two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip):

  • with or without facial pain/pressure

  • with or without reduction or loss of smell

for at least ≥12 weeks, with validation by telephone or interview.

Visualization of polyps on anterior rhinoscopy, nasendoscopy, or CT scan is required to confirm the diagnosis.

Visual analog scale (VAS)[2]

An assessment of the severity of disease can be made using a VAS, which signifies how troublesome symptoms are to patients. The VAS ranges from 0 cm for not troublesome at all to 10 cm for worst imaginable level.

Disease can then be categorized as mild, moderate, or severe based on the result:

  • Mild = VAS score 0-3

  • Moderate = VAS score >3 to 7

  • Severe = VAS score >7 to 10

Endoscopic appearance scores[28]​​

The endoscopic appearance of polyps is graded as follows:

  • Grade 0: absence of polyps

  • Grade 1: small polyps in the middle meatus not reaching below the inferior border of the middle turbinate

  • Grade 2: polyps reaching below the inferior border of the middle turbinate but not completely obstructing the nasal cavity

  • Grade 3: large polyps reaching the lower border of the inferior turbinate or nasal polyps medial to the middle turbinate

  • Grade 4: polyps completely obstructing the nasal cavity

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