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Laryngorhinootologie 2016; 95(S 01): S116-S135
DOI: 10.1055/s-0041-109059
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Evidenz und Evidenzlücken bei der Behandlung der behinderten Nasenatmung und der Rhinosinusitis

Evidence-Based and Evidence-lacking Therapies of Nasal Obstruction and Rhinosinusitis
N. Rotter
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Publication History

Publication Date:
29 April 2016 (online)

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Zusammenfassung

Therapieverfahren in der Hals-Nasen-Ohrenheilkunde beruhen heute auf klinischer Erfahrung, chirurgischer Ausbildung und wissenschaftlicher Evidenz. Seit einigen Jahren gewinnt jedoch der Aspekt der evidenzbasierten Behandlung u. a. wegen des Potenzials zur Verbesserung von individuellen Behandlungen, aber auch aufgrund der wirtschaftlichen Rahmenbedingungen zunehmend an Bedeutung. Gleichzeitig ist es in der klinischen Praxis äußerst schwierig, fast unmöglich, einerseits einen Überblick über die wachsende Anzahl von Publikationen zu behalten, andererseits die publizierten Studien umfassend zu beurteilen, z. B. auch im Hinblick auf mögliche systematische Fehler, um die relevanten und neuesten Studienergebnisse in Therapieentscheidungen miteinzubeziehen. Metaanalysen, Übersichtsarbeiten und Leitlinien spielen deshalb heute eine wachsende Rolle für die evidenzbasierte Therapieplanung.

In dieser Arbeit soll eine aktuelle und möglichst umfassende Übersicht über die Verfügbarkeit externer Evidenz bei der Behandlung der Nasenatmungsbehinderung und der Rhinosinusitis gegeben werden. Dabei wird schnell klar, dass sich beide Erkrankungsbereiche im Hinblick auf die externe Evidenz deutlich unterscheiden. Weiterhin wird klar, dass insbesondere die chirurgischen Verfahren deutlich schwieriger mit Studien höherer Evidenzlevel zu stützen sind, als dies bei medikamentösen Therapien der Fall ist.

Abstract

Therapeutic decisions in otorhinolaryngology are based on clinical experience, surgical skills and scientific evidence. Lately, evidence-based therapies have gained increased attention and importance due to their potential to improve individual patients treatments and their potential to at the same time reduce treatment costs. In clinical practice it is almost impossible to stay ahead of the increasing masses of literature and on the other hand to critically assess the presented data. A solid scientific and statistical knowledge as well as a significant amount of spare time are required to detect systematic bias and other errors in study designs, also with respect to assessing whether a study should be part of an individual therapeutic decision or not. Meta-analyses, reviews and clinical guidelines are therefore of increasing importance for evidence-based therapy in clinical practice.

This review is an update of the availability of external evidence for the treatment of nasal obstruction and rhinosinusitis. It becomes evident that both groups of diseases differ significantly in the availability of external evidence. Furthermore, it becomes obvious that surgical treatment options are usually based on evidence of significantly lower quality than medical treatment options.

Schlüsselwörter

Nasenatmungsbehinderung - Rhinosinusitis - Therapie, Evidenz

Key words

evidence-based therapies - evidence-lacking therapies - nasal obstruction, rhinosinusitis
 

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