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World Allergy Organ J. 2014 Oct 27;7(1):25. doi: 10.1186/1939-4551-7-25. eCollection 2014.

ICON: chronic rhinosinusitis.

Author information

Upper Airways Research Laboratory (URL), University Hospital Ghent, Kragujevac, Belgium.
Div. of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan.
Beijing Key Laboratory of Nasal diseases, Beijing Institute of Otolaryngology, Beijing, China.
Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand.
Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, MA USA.
Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA.
Allergy & Asthma Medical Group & Research Center, San Diego, California USA.
Rhinology Unit & Smell Clinic, Hospital Clínic - IDIBAPS, Barcelona, Catalonia Spain.
Section of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, Illinois USA.
Department of Otorhinolaryngology, Clinics Hospital/University of Sao Paulo Medical School, Kragujevac, Brazil.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Seoul, Korea.
Dept. of Otorhinolaryngology, Showa University, Tokyo, Japan.
Department of Rhinology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
University of Tennessee Health Science Center, Memphis, Tennessee.


Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. Moreover, the complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference. In this document we discuss the definition of the disease, its relevance, pharmacoeconomics, pathophysiology, phenotypes and endotypes, genetics and risk factors, natural history and co-morbidities as well as clinical manifestations and treatment options in both adults and children comprising pharmacotherapy, surgical interventions and more recent biological approaches. Finally, we have also highlighted the unmet needs that wait to be addressed through future research.


Biologicals; Chronic rhinosinusitis; Co-morbidities; Genetics; Pathophysiology; Pharmacoeconomics; Phenotypes; Treatment; Unmet needs

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