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Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 5108

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Special Issue Editor

Prof. Dr. Carl Philpott

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Guest Editor

Rhinology & ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
Interests: rhinosinusitis; olfactory disorders; gustatory disorders; rhinitis; allergic fungal sinusitis

Special Issue Information

Dear Colleagues,

Chronic rhinosinusitis is a common upper airway inflammatory condition that has a detrimental impact on the quality of life of patients. It is managed by a multitude of clinicians including general practitioners, otorhinolaryngologists, respiratory physicians, and immunologists. Traditionally, chronic rhinosinusitis is classified as either being with or without polyps. Since the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020), there has been a shift from phenotype classification to endotype classification of either type-2 inflammation or non-type 2 inflammation subtypes. This reflects the different underlying pathophysiology of chronic rhinosinusitis and the increasing use of targeted therapies such as biologics.

For an upcoming Special Issue of the Journal of Clinical Medicine (PubMed indexed), we invite investigators to contribute original research and review articles focusing on a wide range of topics covering advances in diagnosis, management, and patient experiences in chronic rhinosinusitis. Potential topics may include:

• Phenotypes and Endotypes in Chronic Rhinosinusitis – Where Are We Now?
• Role of the Microbiome in Chronic Rhinosinusitis
• Medical Therapy in Chronic Rhinosinusitis
        • Adherence and Compliance
        • Different Techniques/Devices for Administration of Intranasal Medication
        • Novel Medical Treatments
• Advances in Surgical Treatment of Chronic Rhinosinusitis
        • Awake Surgery
        • New Technology Including AR
        • Latest Evidence from Surgical Trials
• Understanding and Managing Olfaction in Chronic Rhinosinusitis
• Patient Experiences of Living with Chronic Rhinosinusitis

Prof. Dr. Carl Philpott
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

rhinosinusitis
olfactory disorders
gustatory disorders
rhinitis
allergic fungal sinusitis

Published Papers (6 papers)

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Research

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12 pages, 2080 KiB

Open AccessArticle

Comparison of Long-Term Postoperative Outcomes of the Subtypes of Chronic Rhinosinusitis with Nasal Polyps

by Sang-Min Lee, Shin-Hyuk Yoo and Ji-Hun Mo

J. Clin. Med. 2024, 13(6), 1699; https://doi.org/10.3390/jcm13061699 - 15 Mar 2024

Viewed by 557

Abstract

(1) Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition that significantly impacts the health-related quality of life (HRQOL) of patients. This study aims to investigate the disparities in preoperative examination findings, postoperative HRQOL, and disease control status based on CRSwNP subtypes. (2) Methods: A retrospective analysis was conducted on 202 patients who underwent endoscopic sinus surgery for CRSwNP. The study assessed clinical characteristics, blood eosinophil and immunoglobulin E (IgE) levels, modified Lund–Kennedy and Lund–Mackay scores, and Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scores. HRQOL was evaluated using the Sino-nasal Outcome Test (SNOT-22) scores, and disease control status was assessed based on the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 guidelines. (3) Results: Of the 202 patients, Eosinophilic CRSwNP patients exhibited significantly higher preoperative peripheral blood eosinophil ratios and IgE levels, and JESREC scores (p < 0.05). Two years postoperatively, patients in the non-eosinophilic group showed significantly improved SNOT-22 scores compared to preoperative scores (p = 0.007). Notably, the proportion of patients with uncontrolled disease was significantly higher in the eosinophilic group (p = 0.035). Logistic regression analyses identified preoperative SNOT-22 scores and eosinophilic CRSwNP subtype as influential factors on disease control status (p < 0.05). (4) Conclusions: Patients with more severe preoperative symptoms and eosinophilic CRSwNP demonstrated poorer long-term treatment outcomes. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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10 pages, 923 KiB

Open AccessArticle

The Clinical Course of Paranasal Sinus Mucocoeles—A Retrospective Case Series

by Shyam Gokani, Kala Kumaresan, Sushritha Adari, Mehmet Ergisi, Oladapo Oludeye, Lavandan Jegatheeswaran and Carl Philpott

J. Clin. Med. 2024, 13(2), 397; https://doi.org/10.3390/jcm13020397 - 11 Jan 2024

Viewed by 551

Abstract

Paranasal sinus mucocoeles can be secondary to chronic rhinosinusitis and can result in intra-orbital and intra-cranial complications requiring surgical management. The natural history of conservatively managed mucocoeles is not well established. We aimed to quantify the proportion of radiologically identified paranasal sinus mucocoeles resulting in complications over 10 years. We retrospectively reviewed anonymised data on radiologically diagnosed mucocoeles between 2011 and 2021 at two UK hospitals. We collected data on age at presentation, extent of sinus involvement, management and complications. We identified 60 patients with mucocoeles, of which 35 (58%) were incidental findings from radiological investigations. The mean age was 58 years. Fifteen patients (25%) were managed surgically and one presented with recurrence following surgery. Overall, six patients (10%) had an intra-orbital extension of their mucocoele and three (5%) had an intra-cranial extension. There was no difference in the rates of intra-cranial extension between conservative and surgical cases but surgical cases included a higher rate of intra-orbital extensions (27% vs. 4%, p = 0.01). The proportion of patients requiring surgical intervention in this study is low. Incidental and asymptomatic mucocoeles have a relatively benign disease course and selected uncomplicated cases can be considered for conservative management with serial scanning at 12 months. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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11 pages, 876 KiB

Open AccessArticle

Prevalence and Associated Factors of Medication Non-Adherence in CRS Patients following Endoscopic Sinus Surgery

by Shyam Ajay Gokani, Allan Clark, Amin Javer and Carl Philpott

J. Clin. Med. 2023, 12(16), 5381; https://doi.org/10.3390/jcm12165381 - 18 Aug 2023

Viewed by 790

Abstract

This study aimed to evaluate factors that may predispose patients to not adhere to prescribed medication after endoscopic sinus surgery (ESS) and to compare SNOT-22 scores at 0–12 months post-operatively between adherent and non-adherent patients. CRS patients who underwent ESS between 2012 and 2016 were recruited to this retrospective cohort study. Adherence was assessed through a questionnaire and review of medical notes. Ninety-four participants were included (61% male, mean age 60). Of those, 66% did not adhere to their prescribed post-operative CRS medication timing or dosage. The most common reason for non-adherence was improvement of symptoms (17%), followed by deterioration of symptoms (11%) and side effects (10%). Post-operative SNOT-22 scores were lowest for non-intentionally non-adherent (NINA) participants with a mean of 10.5 [95% CI: 7.47–13.5], compared to 25.0 for intentionally non-adherent (INA) [95% CI: 17.6–32.4] and 17.7 for adherent patients [95% CI: 13.7–21.7], p = 0.01. This study identifies that almost two-thirds of patients are not compliant with CRS medications after ESS. NINA participants reported lower post-operative SNOT-22 scores compared to INA and adherent participants. Future studies should focus on educating patients to continue with medications post-operatively despite an initial improvement in symptoms. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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16 pages, 1128 KiB

Open AccessArticle

Understanding the Impact of Chronic Rhinosinusitis with Nasal Polyposis on Smell and Taste: An International Patient Experience Survey

by Louis Luke, Liam Lee, Shyam Ajay Gokani, Duncan Boak, Jim Boardman and Carl Philpott

J. Clin. Med. 2023, 12(16), 5367; https://doi.org/10.3390/jcm12165367 - 18 Aug 2023

Cited by 1 | Viewed by 1121

Abstract

The aim is to understand the patient experience of living with chronic rhinosinusitis with nasal polyposis (CRSwNP), clinician interactions and how symptoms, smell and taste disturbance are managed. An anonymized, online survey was distributed through a UK charity, Fifth Sense, a UK otolaryngology clinic and online support groups to capture qualitative and quantitative data. Data were collected from 1st December 2022 to 1st February 2023. A total of 124 individuals participated. The majority were female (66%) and in the age range of 41–70 years; 74.2% of participants were from the UK with the rest from North America, Europe and Asia. A total of 107 participants declared they had CRSwNP. Rhinologists and general otolaryngology clinicians scored the highest for patient satisfaction whilst general practitioners scored the lowest. Satisfaction with the management of smell and taste disturbance was lower amongst all clinicians compared to overall satisfaction. Ratings correlated with response to therapy and clinician interactions. Respondents reported hyposmia/anosmia to be the most debilitating symptom. Surgery and oral steroids were considered to be effective; however, the benefit lasted less than six months (62%). Hyposmia/anosmia is a key CRSwNP symptom that has limited treatment options and is frequently undervalued by clinicians. There is a need for more effective management options, education and patient support. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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Review

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12 pages, 485 KiB

Open AccessReview

Effects of Probiotic Supplementation during Chronic Rhinosinusitis on the Microbiome

by Arkadiusz Standyło, Aleksandra Obuchowska, Anna Horaczyńska-Wojtaś and Grażyna Mielnik-Niedzielska

J. Clin. Med. 2024, 13(6), 1726; https://doi.org/10.3390/jcm13061726 - 17 Mar 2024

Viewed by 754

Abstract

Probiotics are live microorganisms that induce health benefits to the host. The consumption of probiotics can result in both prophylactic and therapeutic effects. Chronic rhinosinusitis (CRS) is an inflammatory condition that has a significant health and economic impact worldwide. Despite its great burden on the health-care system and patients’ quality of life, the variety of therapy options for CRS is currently limited. Inflammation, mucociliary dysfunction and changes in the microbial environment are thought to be the main factors causing the disease. Probiotics are a relatively new intervention, with a focus on the probiotic qualities and adaptive elements required for a bacterial strain to have a positive impact on CRS. The aim of this review was to review studies evaluating the potential beneficial effects of probiotics in the treatment of chronic rhinosinusitis. Future prospects and difficulties for probiotics in CRS are also highlighted. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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14 pages, 555 KiB

Open AccessReview

Delivery of Topical Drugs to the Olfactory Cleft

by Andreas Espehana, Liam Lee, Elizabeth Mairenn Garden, Gabija Klyvyte, Shyam Gokani, Lavandan Jegatheeswaran, Jeremy Jonathan Wong and Carl Philpott

J. Clin. Med. 2023, 12(23), 7387; https://doi.org/10.3390/jcm12237387 - 29 Nov 2023

Cited by 1 | Viewed by 976

Abstract

Olfactory dysfunction affects approximately 20% of the population globally, with incidence increasing over the age of 60. The pathophysiology is complex, not yet fully understood, and depends on many factors, including the underlying cause. Despite this, the present literature on olfaction is limited due to significant heterogeneity in methodological approaches. This has resulted in limited effective treatments available for olfactory dysfunction. Medications for olfactory dysfunction can be administered locally (directly to the olfactory epithelium) or systemically (orally or intravenously). Currently, there are various methods for local drug delivery to the olfactory epithelium (nasal drops, nasal sprays, atomisers, pressured meter-dosed inhalers, rinses, and exhalation delivery systems). The aims of this review are to summarise the different methods of drug delivery to the olfactory cleft, evaluate the current literature to assess which method is the most effective in delivering drugs to the olfactory epithelium, and review the medications currently available to treat olfactory dysfunction topically. Going forward, further research is required to better establish effective methods of drug delivery to the olfactory epithelium to treat smell disorders. Full article

(This article belongs to the Special Issue Chronic Rhinosinusitis: Advances in Diagnosis, Management and Patient Experience)

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