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Rhinosinusitis treatment

Michael Koennecke, Ludger Klimek, Joaquim Mullol, Philippe Gevaert, Barbara Wollenberg
Background: Chronic rhinosinusitis (CRS) is a heterogeneous, multifactorial inflammatory disease of the nasal and paranasal mucosa. It has not been possible to date to develop an internationally standardized, uniform classification for this disorder. A phenotype classification according to CRS with (CRSwNP) and without polyposis (CRSsNP) is usually made. However, a large number of studies have shown that there are also different endotypes of CRS within these phenotypes, with different pathophysiologies of chronic inflammation of the nasal mucosa...
2018: Allergo Journal International
W C Chen, Y T Chang, S F Chen, W C Lin, Y Y Su, S D Luo
BACKGROUND: Dysregulation of the autonomic system can affect sinonasal physiological function and may exacerbate the symptom burden associated with rhinosinusitis. However, the association between autonomic dysfunction and chronic rhinosinusitis (CRS) has seldom been studied. Here, we investigated the relationship between autonomic dysfunction and CRS. METHODS: Patients with CRS who failed medical treatment were prospectively enrolled. All patients underwent pre-operative examinations and completed questionnaires, including the reflux symptom index (RSI) and the Sino-nasal Outcome Test-22 (SNOT-22)...
March 21, 2018: Rhinology
Gwanghui Ryu, Min Young Seo, Kyung Eun Lee, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung, Sang Duk Hong
INTRODUCTION: Rhinosinusitis in patients who undergo kidney transplantation (KT) might have specific clinical characteristics due to immune status of recipients. The aim of this study was to identify the clinical course of rhinosinusitis after KT and to evaluate the efficacy of routine sinonasal evaluation before KT. METHODS: The study included 1589 kidney transplant adult patients who underwent preoperative sinonasal evaluation including sinonasal symptoms, nasal endoscopy, and plain X-ray between November 1994 and December 2013 (19 years)...
March 20, 2018: European Archives of Oto-rhino-laryngology
Ignacio Javier Fernandez, Francesco Maria Crocetta, Marco Demattè, Paolo Farneti, Marta Stanzani, Russel E Lewis, Martina Fornaciari, Ernesto Pasquini, Vittorio Sciarretta
Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Aaron S Griffin, Peter Cabot, Ben Wallwork, Ben Panizza
The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound clinical evidence. New and emerging treatments, both natural and developed, are numerous, and it remains a challenge for otolaryngologists as well as general practitioners to keep up to date with these therapies and their efficacy. In this systematic review, we discuss a number of alternative therapies for CRS, their proposed physiologic mechanisms, and evidence supporting their use...
March 2018: Ear, Nose, & Throat Journal
Cecilia T Costiniuk, Vikram Mehraj, Jean-Pierre Routy, Christina de Castro, Natale Wasef, Mohammad-Ali Jenabian, Syim Salahuddin, Bertrand Lebouché, Joseph Cox, Jason Szabo, Marina Klein, Larry Lands, Adam J Shapiro
Introduction: Low levels of nasal NO have been associated with increased propensity to rhinosinusitis and respiratory tract infections. Our objective was to describe nasal NO levels in HIV-infected individuals versus healthy controls and determine possible risk factors for reduced nasal NO levels. Materials and Methods: HIV-infected individuals and healthy controls were recruited. Participants underwent nasal NO testing by standardized methods using a CLD88 chemiluminescence analyzer and completed the Sinonasal Outcome Test-20 (SNOT-20) on symptoms of rhinosinusitis...
2018: AIDS Research and Treatment
Giuseppe Brescia, Claudia Zanotti, Daniela Parrino, Umberto Barion, Gino Marioni
PURPOSE: Endotyping chronic rhinosinusitis with nasal polyps (CRSwNP) poses a challenge for rhinologists nowadays. Phenotyping CRSwNP proved inappropriate as an approach to their classification because of their common clinical features. Endotyping, being based on the pathogenic mechanism, provides a precise picture more appropriate for use in clinical practice. Patients' treatment and follow-up can thus be tailored to cope with the degree of aggressiveness of a specific CRSwNP endotype...
March 7, 2018: American Journal of Otolaryngology
Meenu Singh, Nandini Paul, Shreya Singh, Gyan Ranjan Nayak
Asthma is an allergic, respiratory disorder characterized by hyper responsiveness of the airway to external stimuli. Considerable research is currently being directed towards understanding the role of environmental and genetic factors contributing to the development of asthma and its severity. Recent years have seen a substantial rise in evidence linking fungi to asthma. Few major clinical conditions associated with fungal sensitization and hypersensitive immune response are Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal rhinosinusitis (AFRS) and Severe asthma with fungal sensitization (SAFS)...
March 17, 2018: Indian Journal of Pediatrics
Giuseppe Brescia, Daniela Parrino, Lorenzo Nicolè, Claudia Zanotti, Cristiano Lanza, Umberto Barion, Filippo Marino, Gino Marioni
PURPOSE: The term aspirin-exacerbated respiratory disease (AERD) refers to a combination of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and acute respiratory tract reactions to nonsteroidal anti-inflammatory drugs. AERD has now been included among the CRSwNP endotypes, and is considered one of the most aggressive in terms of disease recurrence. Cortactin is a multi-domain protein with a part in several cellular mechanisms involving actin assembly and cytoskeleton arrangement...
March 5, 2018: American Journal of Otolaryngology
Tina D Hunter, Adam S DeConde, R Peter Manes
AIMS: The objective of this study was to quantify the treatment costs and revision surgery rates in chronic rhinosinusitis (CRS) patients, with and without nasal polyposis (CRSwNP and CRSsNP), who require treatment with endoscopic sinus surgery (ESS). The additive contributions of nasal polyposis (NP) and revision surgery to 1-year costs were a primary focus. MATERIALS AND METHODS: Adults (age 18-64) undergoing ESS for CRS in 2012-2015 were identified within the Blue Health Intelligence database and used to estimate revision rates...
March 14, 2018: Journal of Medical Economics
Seung-Heon Shin, Mi-Kyung Ye, Sung-Yong Choi, Kwan-Kyu Park
Bee venom (BV) has long been used as anti-inflammatory agent in traditional oriental medicine; however, the effect of BV on chronic rhinosinusitis (CRS) is not commonly studied. The aim of the present study was to determine the anti-inflammatory effect of BV on an allergic CRS mouse model. An allergic CRS mouse model was established following the administration of ovalbumin with Staphylococcus aureus enterotoxin B (SEB) into the nose. A total of 0.5 or 5 ng/ml of BV were intranasally applied 3 times a week for 8 weeks...
March 9, 2018: Molecular Medicine Reports
Kwan-Sub Kim, Nam-Kyung Yeo, Seong-Su Kim, Woong-Sub Park, Su-Hyun Kwak, Sang-Hyeon Cho, Gyu-Wan Sung, Hae-Sook Kim, Sang-Wook Yi, Hae Jun Cho
PURPOSE: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty. METHODS: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study...
March 1, 2018: Annals of Otology, Rhinology, and Laryngology
Josephine Bryk Rose, Sarah Davies, Kadie M Anderson, Graeme S Allan, Patricia M Dennis, Richard Malik
An approximately 4-yr-old female Bennett's wallaby ( Macropus rufogriseus) was evaluated for chronic left-sided facial swelling and nasal discharge. Computed tomography, endoscopy, biopsy, mycologic culture, and panfungal polymerase chain reaction were consistent with destructive mycotic rhinosinusitis. The patient's infection was treated with a long-term injectable antibiotic, oral antifungal therapy, and multiple intranasal infusions of voriconazole suspended in a reverse thermodynamic pluronic gel. This case represents the first documented case of mycotic rhinosinusitis in a macropod and underlines the importance of advanced cross-sectional imaging in the diagnosis, monitoring, and management of nasal cavity disease in zoo animals...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Ravi Jain, Michael Hoggard, Melissa Zoing, Yannan Jiang, Kristi Biswas, Michael W Taylor, Richard G Douglas
BACKGROUND: Antibiotics and corticosteroids are prescribed to patients with chronic rhinosinusitis (CRS) to reduce bacterial burden and mucosal inflammation. Unfortunately, clinical improvement is often short-lived and symptoms frequently recur following cessation of treatment. The impact of these systemic therapies on bacterial communities is not well understood. Improved knowledge of how medical therapies influence the intranasal ecosystem may allow for more effective prescribing and the development of more targeted treatments...
March 8, 2018: International Forum of Allergy & Rhinology
Aakanksha Rathor, Abhinandan Bhattacharjee
Objective: This study aimed to determine whether there is a clinical-radiological correlation in chronic rhinosinusitis (CRS), to compare operative findings with those of computed tomography (CT) imaging, and to determine the importance of a CT score and staging in management of CRS. Methods: This study is a prospective study. Adult patients meeting diagnostic criteria for CRS were prospectively studied using the Lund-Mackay (LM) symptom score and sinus CT scan...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Yang Liu, Yin Yao, Zhi-Chao Wang, Qing Ning, Zheng Liu
Host immunity (innate and adaptive immunity) plays essential roles in the pathogenesis of inflammatory upper airway diseases including allergic rhinitis and chronic rhinosinusitis. Recently, the discovery of novel innate immune cells, particularly innate lymphoid cells, has renewed our view on the role of innate immunity in inflammatory upper airway diseases. Meanwhile, the identification of new subsets of T helper (Th) cells including Th22, Th9 and follicular Th cells, and regulatory B cells in the adaptive immunity has broadened our knowledge on the complex immune networks in inflammatory upper airway diseases...
March 7, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
M Koennecke, R Pries, B Wollenberg
Chronic rhinosinusitis is a heterogeneous group of inflammatory diseases with significant annual costs for the health care system. To date, there is no distinct signaling pathway known that explains the entire process from the beginning to tissue transformation. Due to the diversity of chronic rhinosinusitis, no uniform treatment has yet been developed. With a focus on chronic rhinosinusitis with nasal polyps (CRSwNP), molecular biologic gene expression studies have been performed to identify specific characteristics of nasal polyps that might allow the development of new therapeutic procedures...
March 6, 2018: HNO
David R M Smith, F Christiaan K Dolk, Koen B Pouwels, Morag Christie, Julie V Robotham, Timo Smieszek
Objectives: To assess the appropriateness of prescribing systemic antibiotics for different clinical conditions in primary care, and to quantify 'ideal' antibiotic prescribing proportions in conditions for which antibiotic treatment is sometimes but not always indicated. Methods: Prescribing guidelines were consulted to define the appropriateness of antibiotic therapy for the conditions that resulted in antibiotic prescriptions between 2013 and 2015 in The Health Improvement Network (THIN) primary care database...
February 1, 2018: Journal of Antimicrobial Chemotherapy
Katherine L Whitcroft, Mandy Cuevas, Peter Andrews, Thomas Hummel
BACKGROUND: Our primary aim in this study was to determine which of the "Sniffin' Sticks" subtest components (threshold, discrimination, or identification) best reflect overall change in olfactory function during treatment for chronic rhinosinusitis (CRS). Our secondary aim was to determine whether duration of CRS affects olfactory outcomes after treatment. METHODS: A retrospective cohort study was performed. Sniffin' Sticks test scores from patients medically treated for CRS at our center from 1999 to 2016 were analyzed...
February 26, 2018: International Forum of Allergy & Rhinology
G M Oakley, J M Christensen, R Sacks, P Earls, R J Harvey
INTRODUCTION: The anti-inflammatory effects of long term low dose macrolide therapy have shown benefit in the management of diffuse panbronchiolitis. Dramatic responses to macrolide in the upper airway are seen but our understanding of the patient phenotype predisposing to macrolide response in chronic rhinosinusitis (CRS) is poor. METHODS: A case control study was performed in a tertiary level rhinology practice of consecutive chronic rhinosinusitis patients placed on a 3-month low dose macrolide therapy after failing at least 3 months of corticosteroid irrigation therapy post-endoscopic sinus surgery...
February 24, 2018: Rhinology
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