ERS | monograph Introduction Claus Bachert1,2, Arnaud Bourdin3 and Pascal Chanez4 In 2001, the European Respiratory Society welcomed a Monograph entitled “The Nose and Lung Diseases” [1] and one of the original Guest Editors, Philippe Godard (1948–2011), was instrumental in gathering people around the idea that the nose is the most easily accessible part of the airways. With this new ERS Monograph we would like to again emphasise the notion within our chest community that the nose and sinuses belong to the airway tree, and that it is part of our duty as chest clinicians to think about the upper airways in all our common diseases and to consider our ENT colleagues as important partners in improving the quality of life of our patients. The links between the upper and lower airways are numerous, including anatomical, physiological, triggers and risk factors. The presence of these strong relationships argues for a constant dialogue between specialists and we hope that the comprehensive overview presented in the various chapters herein will contribute to reinforce the willingness of our colleagues to undertake fruitful collaboration in order to increase our knowledge with the ultimate goal of improving patient care. The first three chapters cover anatomy, imaging and clinical examination, within the approach of the “united airways” concept. This approach should consider a pragmatic understanding of the situation, subject to the constraints of human and financial resources, leading to the best compromise to establish a clear diagnosis. Mutual understanding between chest physicians and ENT specialists is the guiding principle. We should understand the real involvement of the upper airways in all chronic respiratory disorders and consider them as “morbidities” rather than comorbid conditions. The association of nasal polyposis and asthma and the complex pathophysiological landscape is covered by chapters focusing on chronic infection and its potential impact on immunity, and the perspectives of both ENT and chest physicians. Sino-nasal involvement in cystic fibrosis and COPD patients requires specific attention, not only as a source of potential triggering pathways but also as a matter of persistent complaints. The subjective symptoms, including fatigue, impaired sleep quality, dyspnoea and mucus secretion, should direct more attention to the upper airways. Risk factors, triggers and other associated influences are important, but direct causality is often difficult to demonstrate and a strong Copyright ©ERS 2017. Print ISBN: 978-1-84984-085-9. Online ISBN: 978-1-84984-086-6. Print ISSN: 2312-508X. Online ISSN: 2312-5098. Correspondence: Pascal Chanez, Respiratory Medicine APHM, INSERM U1067, Aix-Marseille University, 7 rue Scudery, 130007 Marseille, France. E-mail: 1 Upper Airways Research Laboratory, Ghent University, Ghent, Belgium. 2 Division of ENT Diseases, CLINTEC, Karolinska Institute, Stockholm, Sweden. 3 Département de Pneumologie et Addictologie and PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Hôpital Arnaud de Villeneuve, CHU Montpellier, Montpellier, France. 4 Respiratory Medicine APHM, INSERM U1067, Aix-Marseille University, Marseille, France. xi
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