Updates and Innovative Solutions for CRS Patients: The Brazilian Experience

PROGRAM DESCRIPTION: Chronic rhinosinusitis (CRS) is a prevalent, multifactorial disease that causes a great burden on patients' quality of life and has a deep economic impact. The treatment of CRS has undergone a dramatic advance in recent years after the understanding of different endophenotypes of CRS patients, and, as a result, personalized treatments with a greater chance of success have emerged, with special emphasis on immunobiological drugs. However, differences in the ethnic and type of inflammation of CRS patients worldwide and cultural and economic reality may directly impact treatment outcomes and determine different protocols.
In this panel, we will present the recent advances in the endotype and phenotype characteristics of patients with CRS with Nasal Polyps in Brazil, a country marked by great ethnic and economic diversity. Our data bring a better understanding of the pathophysiology and consequently a better picture of this disease's medical and surgical management.
We will discuss the stepwise approach for the “endophenotypic” diagnosis of CRS in clinical practice, including the main laboratory tests and relevant clinical characteristics that may impact treatment outcomes. We will also present the best practices currently adopted in a developing country, considering the economic issues and accessibility to surgery and novel medical therapies, with the objective of treating the greatest number of people in the best possible way.
Finally, we will highlight the importance of objectively assessing smell as a method for diagnosing and monitoring CRS. We will present a new digital scent device (DSD) for olfactory assessment. The DSD olfactory test is a feasible and reliable odor identification test. It employs a self-administered, portable device that controls the duration of odor release to the nasal cavity through a touchscreen digital interface with automatic database generation. Furthermore, the DSD is cost-effective and efficient. The digitalization of olfactory assessment combined with data science opens new research perspectives in the field of olfaction.

OUTCOME OBJECTIVE 1: To recognize the main endophenotypes of CRS in the Brazilian population and to show the most relevant biomarkers in the clinical practice.

OUTCOME OBJECTIVE 2: To demonstrate how the current protocols for CRS treatment are being adapted to a developing country, considering accessibility and cost-effectiveness issues of new treatments.

OUTCOME OBJECTIVE 3: To implement and interpret a new olfactory digital assessment test in clinical practice.

BACKGROUND STATEMENT: Endophenotyping in CRS patients from developing countries is still not well established.
Adaptations in current protocols may apply to developing countries.
Novel and cost-effective olfactory tests are still required worldwide