Page 20 - Portuguese Journal - SPORL - Vol 61. Nº2

Figure 4
Indications for biologics, the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020.

*exceptional circumstances are excluded (e.g., without conditions for durgery). ESS, endoscopic sinonasal surgery

Figure 5
Chronic rhinosinusitis with severe and uncontrolled polyposis

or previous sinonasal surgery (unless there is a polyposis that takes into consideration the
clinical contraindication for surgery) . initial pharmacological treatment, surgical
1
Biologic agents are indicated for patients treatment, and treatment with biologic
with CRS with serious/severe sinonasal agents in patients with severe disease that is
polyposis that is not controlled with difficult to control.
conventional treatment (surgery and/or
systemic corticosteroids always in association Methods
with the initial pharmacological treatment) . The proposals of the two main international
1
It is important to establish a therapeutic working groups on this topic, the European
algorithm for the management of CRS with Position Paper on Rhinosinusitis and Nasal

162 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery