Sinusitis

20 pages, 546 KB

Open AccessReview

Radiation-Induced Rhinosinusitis After Treatment of Nasopharyngeal and Selected Sinonasal Cancers: A Narrative Review

by Olawunmi O. Oyedeji and Emmanuel O. Oisakede

Sinusitis 2026, 10(1), 15; https://doi.org/10.3390/sinusitis10010015 - 22 Jun 2026

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Radiotherapy is central to the treatment of nasopharyngeal carcinoma and selected sinonasal malignancies, but sinonasal toxicity remains incompletely characterized. Radiation-induced rhinosinusitis (RIR) is increasingly recognized after head-and-neck radiotherapy, particularly in nasopharyngeal carcinoma, where the paranasal sinuses and drainage pathways may receive substantial incidental [...] Read more.

Radiotherapy is central to the treatment of nasopharyngeal carcinoma and selected sinonasal malignancies, but sinonasal toxicity remains incompletely characterized. Radiation-induced rhinosinusitis (RIR) is increasingly recognized after head-and-neck radiotherapy, particularly in nasopharyngeal carcinoma, where the paranasal sinuses and drainage pathways may receive substantial incidental dose. Reported prevalence varies widely because studies use different endpoints, including radiologic mucosal thickening, endoscopic inflammation, and patient-reported symptoms. Across available nasopharyngeal carcinoma cohorts, imaging-defined sinonasal inflammatory changes are common, with reported rates generally ranging from approximately 30% to more than 70% depending on timing, radiation technique, and diagnostic criteria. This narrative review summarizes current evidence on the epidemiology, pathophysiology, dosimetric predictors, imaging findings, prevention, and management of RIR. Radiation-induced sinonasal injury appears to arise from epithelial damage, impaired mucociliary clearance, altered local defense, and chronic mucosal remodeling. Available data suggest that higher doses to the paranasal sinuses and drainage pathways, baseline sinus disease, and tumor extension into sinonasal structures increase risk, although validated dose constraints are not yet established. We propose a harmonized reporting framework that integrates symptoms, endoscopy, imaging, dosimetry, baseline sinonasal status, and oncologic context. Greater recognition of RIR as a clinically meaningful survivorship toxicity may support more consistent outcome reporting, prospective studies, and future radiation-planning strategies aimed at reducing sinonasal morbidity. Full article

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12 pages, 1351 KB

Open AccessArticle

Clinical and Radiological Diagnosis of Oroantral Communication: A Retrospective Outpatient Study

by Dumitru Hîţu, Nicolae Chele, Victoria Ciobanu, Mihaela Dandara, Vasile Cabac and Sergiu Parii

Sinusitis 2026, 10(1), 14; https://doi.org/10.3390/sinusitis10010014 - 11 Jun 2026

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Abstract

Background: Oroantral communication (OAC) represents a pathological communication between the oral cavity and the maxillary sinus, most commonly occurring after extraction of posterior maxillary teeth. Despite being considered a rare complication, it remains clinically significant due to the risk of chronic sinus pathology. [...] Read more.

Background: Oroantral communication (OAC) represents a pathological communication between the oral cavity and the maxillary sinus, most commonly occurring after extraction of posterior maxillary teeth. Despite being considered a rare complication, it remains clinically significant due to the risk of chronic sinus pathology. Methods: This study was conducted within the “Arsenie Guțan” Department of Oral and Maxillofacial Surgery at “Nicolae Testemițanu” State University of Medicine and Pharmacy. We evaluated a cohort of 31 patients with OAC treated in an outpatient setting at the Municipal Dental Center in Chișinău during 2022. Results: The first molar was the most frequently involved tooth (45.16%), with molars accounting for 83.88% of cases. Immediate post-extraction diagnosis was achieved in 90.32% of patients. Imaging was required in selected cases, with orthopantomography (OPG) used in 83.87% and computed tomography (CT) in 9.67% of patients. Conclusions: Early diagnosis based on combined clinical and radiographic assessment remains essential for successful management of OAC. Prompt intervention reduces the risk of maxillary sinus infection and chronic fistula formation. Full article

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9 pages, 592 KB

Open AccessCommentary

When “Sinusitis” Is Actually Cancer: Diagnostic Red Flags for Unilateral or Refractory Sinonasal Disease

by Emmanuel O. Oisakede

Sinusitis 2026, 10(1), 13; https://doi.org/10.3390/sinusitis10010013 - 10 Jun 2026

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Abstract

Sinonasal malignancies are rare, accounting for fewer than 3% of head and neck cancers, but their early presentation often overlaps with benign rhinosinusitis. Unilateral nasal obstruction, rhinorrhoea, facial pressure, and intermittent epistaxis may initially appear inflammatory, which contributes to diagnostic delay and late-stage [...] Read more.

Sinonasal malignancies are rare, accounting for fewer than 3% of head and neck cancers, but their early presentation often overlaps with benign rhinosinusitis. Unilateral nasal obstruction, rhinorrhoea, facial pressure, and intermittent epistaxis may initially appear inflammatory, which contributes to diagnostic delay and late-stage presentation. Recent clinical guidance emphasizes that persistent unilateral symptoms, especially when accompanied by bleeding, focal endoscopic abnormalities, or orbital, dental, or neurologic features, should prompt specialist assessment rather than repeated empiric treatment. This commentary argues that the central clinical problem is not failure to recognize advanced disease, but failure to reconsider a benign working diagnosis when “sinusitis” stops behaving like sinusitis. This commentary proposes a pragmatic triage framework for unilateral or refractory sinonasal disease that prioritizes pattern recognition, focused nasal endoscopy, appropriate imaging, and timely biopsy where indicated. Its contribution is to connect three clinically relevant observations: sinonasal malignancy is rare and therefore easily deprioritized; unilateral, progressive, refractory, bleeding, orbital, dental, or neurologic features should prompt earlier cancer exclusion; and emerging AI-assisted endoscopy should currently be viewed only as a triage adjunct, not a substitute for imaging, histopathology, or multidisciplinary assessment. Full article

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8 pages, 829 KB

Open AccessArticle

Outcomes and Tolerability of Office-Based Endoscopic Polypectomy for Chronic Rhinosinusitis with Nasal Polyps: A Prospective Study

by Henrik Andersson, Peter Ebrelius, Per von Hofsten, Linus Schiöler and Gunnhildur Gudnadottir

Sinusitis 2026, 10(1), 12; https://doi.org/10.3390/sinusitis10010012 - 31 May 2026

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Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by bilateral and multifocal polyps and has been shown to decrease health-related quality of life (HRQOL). Standard treatment includes steroids and endoscopic sinus surgery. Office-based endoscopic polypectomy has become increasingly popular in recent years. This [...] Read more.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by bilateral and multifocal polyps and has been shown to decrease health-related quality of life (HRQOL). Standard treatment includes steroids and endoscopic sinus surgery. Office-based endoscopic polypectomy has become increasingly popular in recent years. This study aimed to evaluate the outcomes and tolerability of office-based endoscopic polypectomy using a microdebrider under local anesthesia. This prospective observational study enrolled 19 patients with CRSwNP, according to the EPOS2020 criteria. All patients underwent office-based endoscopic polypectomy. Efficacy of treatment was assessed using the SNOT-22 questionnaire three and six months postoperatively. The perioperative experiences of patients and surgeons were evaluated using questionnaires. The mean SNOT-22 score decreased from 59.7 (SD 21.8) to a mean of 37.1 (SD 26.6 p < 0.001) after three months, and was maintained at 6 months, with a mean of 35.2 (SD 17.6 p < 0.001). The majority reported good comfort levels and did not prefer performing the procedure in an operating room under general anesthesia. The results show that office-based endoscopic polypectomy under local anesthesia is an effective method for relieving symptoms (SNOT-22) and is well-tolerated. The effect was maintained after six months. Full article

(This article belongs to the Special Issue Nasal Polyposis in Chronic Rhinosinusitis: Recent Advances in Diagnosis and Management)

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6 pages, 163 KB

Open AccessTechnical Note

The Hand Lothrop: A Zero-Degree Endoscopic Draf III Procedure with a Kerrison Rongeur

by Nathan Yang, Anton Savin, Rodney J. Schlosser and David A. Gudis

Sinusitis 2026, 10(1), 11; https://doi.org/10.3390/sinusitis10010011 - 21 May 2026

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Abstract

Powered instruments such as drills are commonly used in the endoscopic modified Lothrop procedure, also known as Draf III frontal sinusotomy. However, the use of drills may be associated with increased bone exposure, prolonged postoperative healing, synechiae and crust formation, and mechanical injury [...] Read more.

Powered instruments such as drills are commonly used in the endoscopic modified Lothrop procedure, also known as Draf III frontal sinusotomy. However, the use of drills may be associated with increased bone exposure, prolonged postoperative healing, synechiae and crust formation, and mechanical injury to the nasal vestibule. The objective of this study is to present a simple alternative method for manually performing the endoscopic modified Lothrop procedure using a Kerrison rongeur and a 0-degree endoscope. A surgical candidate for an endoscopic modified Lothrop procedure was identified, and informed consent was obtained to record surgical footage to illustrate the technique. This article describes an alternative technique for performing the endoscopic modified Lothrop procedure using manual instruments, thereby avoiding the use of powered drills and potentially allowing for maximal preservation of the frontal recess mucosa. In addition, the technique enables the procedure to be performed without the use of angled endoscopes, facilitating surgical maneuvers. A summary table outlining each step of the procedure with technical tips, as well as a surgical video illustrating the technique, are also presented. This manual Draf III frontal sinusotomy technique may complement the surgical armamentarium of the frontal sinus surgeon. Full article

8 pages, 209 KB

Open AccessCommentary

Vestibular Symptoms: An Underrecognized Extra-Sinonasal Dimension of Chronic Rhinosinusitis

by Luca Galassi, Niccolò Le Donne, Beatrice Faitelli, Mattia Onesti, Francesca Piacente and Gabriele Carioti

Sinusitis 2026, 10(1), 10; https://doi.org/10.3390/sinusitis10010010 - 12 May 2026

Viewed by 824

Abstract

Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease traditionally defined and assessed by sinonasal symptoms such as nasal obstruction, rhinorrhea, facial pressure, and olfactory dysfunction. However, the burden of CRS extends beyond the sinonasal compartment, including a range of systemic and functional complaints [...] Read more.

Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease traditionally defined and assessed by sinonasal symptoms such as nasal obstruction, rhinorrhea, facial pressure, and olfactory dysfunction. However, the burden of CRS extends beyond the sinonasal compartment, including a range of systemic and functional complaints that are not routinely addressed in standard rhinologic practice. Among these, vestibular symptoms, including dizziness, imbalance, and nonspecific disequilibrium, are frequently reported by patients with CRS, yet remain underrecognized and poorly integrated into current diagnostic frameworks and clinical guidelines, despite being captured as a single, psychometrically limited item within the 22-item Sinonasal Outcome Test (SNOT-22). Clinical observations and limited published data, mostly small observational studies and case reports, suggest that vestibular symptoms may fluctuate in parallel with CRS disease activity and may improve following effective medical or surgical control of sinonasal inflammation. Proposed mechanisms include Eustachian tube dysfunction, immune-mediated and neurogenic pathways, trigemino-vestibular interactions, and altered multisensory integration, although current evidence does not establish a causal relationship between CRS disease activity and measurable peripheral vestibular dysfunction. Comparative observations in allergic rhinitis and post-viral upper-airway inflammation situate CRS within a broader inflammatory upper-airway–vestibular interface. This Commentary highlights vestibular dysfunction as an underappreciated extra-sinonasal dimension of CRS with potential clinical and functional relevance. By drawing attention to this clinical blind spot, we aim to encourage more systematic symptom inquiry, interdisciplinary dialogue, and prospective research into the functional consequences of chronic upper-airway inflammation. Full article

29 pages, 1684 KB

Open AccessReview

Air Pollution as a Driver of Recurrent Upper-Airway Infections and Comorbid Health Issues

by Hassan Ali, Petya Marinova and Tsvetelina Velikova

Sinusitis 2026, 10(1), 9; https://doi.org/10.3390/sinusitis10010009 - 22 Apr 2026

Cited by 1 | Viewed by 1237

Abstract

Air pollution represents a critical yet modifiable factor influencing the recurrence and progression of upper-airway infections. This review explores the molecular, immunological, and environmental mechanisms linking airborne pollutants to recurrent sinus and respiratory tract inflammation. Particular focus is placed on pollutant-induced oxidative stress, [...] Read more.

Air pollution represents a critical yet modifiable factor influencing the recurrence and progression of upper-airway infections. This review explores the molecular, immunological, and environmental mechanisms linking airborne pollutants to recurrent sinus and respiratory tract inflammation. Particular focus is placed on pollutant-induced oxidative stress, epithelial barrier disruption, alterations in the microbiome, and immune dysregulation, which collectively heighten disease susceptibility. Integrating recent advances in exposomics, multi-omics, and artificial intelligence, the discussion highlights new approaches to unravel exposure–response pathways and identify predictive biomarkers. Future directions emphasize precision exposure assessment, interventional strategies to improve air quality, and the emerging framework of “clean-air medicine” to guide prevention and policy. Overall, this synthesis underscores the urgent need for multidisciplinary collaboration across environmental science, molecular biology, and clinical research to mitigate the growing burden of pollution-related airway disease and promote sustainable respiratory health. Full article

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13 pages, 1206 KB

Open AccessSystematic Review

Multifactorial Analysis of Central Compartment Atopic Disease: Atopy, Comorbid Asthma and Radiological Sinus Involvement

by Eugenio Errico, Laura Terradico, Domenica Giunta, Sveva Introini, Fabio Sovardi and Fabio Pagella

Sinusitis 2026, 10(1), 8; https://doi.org/10.3390/sinusitis10010008 - 16 Apr 2026

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Abstract

Background: Central compartment atopic disease (CCAD) is a recently developed terminology used to describe a specific phenotype of chronic rhinosinusitis (CRS). The aim of this study is to provide a thorough analysis of the clinical and radiological characteristics by assessing the prevalence [...] Read more.

Background: Central compartment atopic disease (CCAD) is a recently developed terminology used to describe a specific phenotype of chronic rhinosinusitis (CRS). The aim of this study is to provide a thorough analysis of the clinical and radiological characteristics by assessing the prevalence of symptoms, asthma, allergy, aeroallergen sensitization and radiological sinus involvement. Methods: The authors searched for articles on PubMed, Cochrane, and Embase databases. A review of the articles was carried out following PRISMA guidelines; all articles were assessed for quality according to NICE criteria. Afterwards, the meta-analysis was performed with STATA 18SE software. Studies were also assessed for heterogeneity and risk of publication bias. Mean Lund-Mackay (LMK) score of patients with and without CCAD was compared. Results: A total of 16 studies were included, including 1254 patients with CRS; 537 of these were diagnosed with CCAD. The most prevalent symptoms were obstruction at 78% and congestion at 70%, followed by rhinorrhea at 66%, hyposmia at 54%, and facial pain at 24%. Dust mite at 71% was the most prevalent sensitization. Overall, the prevalence of asthma in patients with CCAD was 26%, prevalence of allergy was 67%. The mean difference in LMK scores was −3.38 in CCAD. Conclusions: Patients frequently present with nasal obstruction and congestion; the most common allergen sensitization is to dust mites. Findings on allergy and asthma prevalence support the “Unified Airway Disease” concept and emphasize the importance of a multidisciplinary approach to managing this phenotype. CCAD patients usually do not develop very high LMK scores; high scores may rule out this diagnosis. PROSPERO registration number: CRD420261361696. Full article

(This article belongs to the Special Issue United Airways: Advances in the Prevention, Diagnosis, and Management of Sinusitis and Asthma)

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8 pages, 909 KB

Open AccessArticle

Role of the Lund–Mackay Score in Determining Surgical Indication in Odontogenic Chronic Rhinosinusitis

by Krystof Zuska, Jakub Fuksa, Mikuláš Knotek, Michal Sisák and Petr Schalek

Sinusitis 2026, 10(1), 7; https://doi.org/10.3390/sinusitis10010007 - 13 Apr 2026

Cited by 1 | Viewed by 924

Abstract

Computed tomography (CT) of the paranasal sinuses is essential in diagnosing odontogenic chronic rhinosinusitis. Treatment primarily targets the dental focus, with endoscopic sinus surgery (ESS) indicated when necessary. Assessing CT findings using the Lund–Mackay score (LMS) may guide therapeutic decisions. This study retrospectively [...] Read more.

Computed tomography (CT) of the paranasal sinuses is essential in diagnosing odontogenic chronic rhinosinusitis. Treatment primarily targets the dental focus, with endoscopic sinus surgery (ESS) indicated when necessary. Assessing CT findings using the Lund–Mackay score (LMS) may guide therapeutic decisions. This study retrospectively compared LMS, dental pathology type, and reported symptoms with treatment choices in patients treated for odontogenic chronic rhinosinusitis between 2012 and 2022 at a tertiary otorhinolaryngology center. Of 2067 chronic rhinosinusitis patients, 61 had an odontogenic cause. LMS was determined in 57 patients and correlated with treatment strategy. Dental pathology subtypes and presenting symptoms were also analyzed. A control group of 25 patients with localized, non-odontogenic chronic rhinosinusitis was included. Fifteen patients not undergoing ESS had lower LMS values (median one), while 42 surgical patients had higher scores (median six). Periapical pathology (47.4%) and oroantral fistula (26.3%) were the most common causes. Nasal discharge and pain were the most frequent symptoms. Neither dental pathology type nor symptoms significantly influenced treatment decisions. The extent of CT-detected pathology, reflected by LMS, can serve as a key criterion in determining treatment for odontogenic chronic rhinosinusitis, independent of symptoms or specific dental pathology type. Full article

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13 pages, 247 KB

Open AccessReview

The Confluence of Chronic Rhinosinusitis and Obstructive Sleep Apnea: A Narrative Review of Pathophysiology, Epidemiology, and Therapeutic Interventions

by Felipe Castillo-Farias, Javier Duran, Pamela Bustos, Pilar Fernandez, Francisca Becker, Alberto Landaida, Gustavo Cañar-Parra, Jolie Crespo, Cristobal Langdon and Paula Mackers

Sinusitis 2026, 10(1), 6; https://doi.org/10.3390/sinusitis10010006 - 31 Mar 2026

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Abstract

Background: Chronic rhinosinusitis (CRS) and obstructive sleep apnea (OSA) frequently coexist, sharing inflammatory and anatomical pathways consistent with the “United Airway”. This review examines the synergistic dysfunction linking these conditions. Methods: We conducted a narrative review synthesizing literature on the epidemiology, pathophysiology—including cytokine [...] Read more.

Background: Chronic rhinosinusitis (CRS) and obstructive sleep apnea (OSA) frequently coexist, sharing inflammatory and anatomical pathways consistent with the “United Airway”. This review examines the synergistic dysfunction linking these conditions. Methods: We conducted a narrative review synthesizing literature on the epidemiology, pathophysiology—including cytokine cascades and microbiome dysbiosis—and therapeutic outcomes of surgical and medical interventions for comorbid CRS and OSA. Results: Large-scale datasets confirm CRS as an independent risk factor for OSA. Pathophysiologically, the disorders are linked by mechanical obstruction, systemic cytokine spillover (IL-6, TNF-a), and nasopharyngeal microbiome dysbiosis (e.g., S. aureus biofilms). Therapeutically, Endoscopic Sinus Surgery (ESS) significantly improves subjective sleep quality (SNOT-22) and reduces CPAP pressure requirements, although it yields only trivial reductions in the Apnea-Hypopnea Index (AHI). Biologics like Dupilumab demonstrate rapid efficacy in improving sleep domains for CRS with nasal polyps. Conclusions: CRS and OSA are inextricably linked via mechanical and inflammatory mechanisms. A holistic “United Airway” management approach—optimizing nasal patency to facilitate CPAP adherence and reduce systemic inflammatory burden—is critical for improving patient outcomes. Full article

(This article belongs to the Special Issue Rhinosinusitis, Its Comorbidities and Complications: Evolving Insights into Mechanisms and Clinical Management)

12 pages, 1353 KB

Open AccessReview

Gut–Sinus Axis and the Role of the Microbiome in the Pathogenesis of Chronic Rhinosinusitis: A Literature Review

by Vivekanand Ashok, Mikash Mohan, Shruthi Sasidharan, Theertha V. Mampally, Sama Sajeed and Anna Juline

Sinusitis 2026, 10(1), 5; https://doi.org/10.3390/sinusitis10010005 - 12 Mar 2026

Viewed by 2017

Abstract

Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the nasal and paranasal mucosa, typically attributed to local infection or anatomical obstruction. However, recent evidence suggests that CRS may also reflect systemic inflammatory dysregulation influenced by the gut microbiome, establishing a potential ‘gut–sinus [...] Read more.

Chronic rhinosinusitis (CRS) is a persistent inflammatory disorder of the nasal and paranasal mucosa, typically attributed to local infection or anatomical obstruction. However, recent evidence suggests that CRS may also reflect systemic inflammatory dysregulation influenced by the gut microbiome, establishing a potential ‘gut–sinus axis’. This systematic review aims to synthesise current evidence linking gut microbiome alterations to the pathogenesis and clinical course of CRS and to explore emerging therapeutic strategies targeting this axis. Five databases were comprehensively searched for studies published between January 2000 and October 2025. Data were extracted and evaluated for quality using the JBI and SYRCLE tools. A total of 441 records were retrieved, of which 20 studies met the inclusion criteria. Human studies consistently showed gut dysbiosis in CRS, characterised by reductions in Roseburia, Bifidobacterium, Faecalibacterium and Akkermansia species. These microbial shifts correlated with increased levels of systemic cytokines, such as interleukin-6, interleukin-17 and tumour necrosis factor-α, and disease severity. Animal and interventional studies confirmed that high-fibre diets and short-chain fatty acid (SCFA) supplementation modified airway inflammation, whereas antibiotic-induced dysbiosis exacerbated it. Current evidence substantiates a gut–sinus axis mediated by immune, metabolic and neuroendocrine pathways. Dysbiosis-driven reductions in SCFA-producing bacteria appear central to systemic pro-inflammatory signalling implicated in CRS. Full article

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6 pages, 1741 KB

Open AccessCase Report

Fungal Sinusitis Masquerading as Trigeminal Neuralgia in an Immunocompetent Patient: A Case Report

by Owen Tsung Wen Ho, Alex Chengyao Tham and Kok Yuen Ho

Sinusitis 2026, 10(1), 4; https://doi.org/10.3390/sinusitis10010004 - 23 Feb 2026

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Abstract

Previous cases of trigeminal neuralgia (TN) caused by fungal sinusitis have been reported, but mainly in immunocompromised patients. We present a case of fungal sinusitis masquerading as trigeminal neuralgia in an immunocompetent patient and discuss the potential implications of these two diseases. The [...] Read more.

Previous cases of trigeminal neuralgia (TN) caused by fungal sinusitis have been reported, but mainly in immunocompromised patients. We present a case of fungal sinusitis masquerading as trigeminal neuralgia in an immunocompetent patient and discuss the potential implications of these two diseases. The patient is a 59-year-old male who presented with a four-year duration of left facial pain. He had been diagnosed and treated for trigeminal neuralgia by a pain specialist but was subsequently referred to ENT after a MRI of the brain showed left maxillary sinusitis. Nasoendoscopy findings and a CT scan of the paranasal sinuses were concordant with left maxillary sinusitis. The patient underwent left functional endoscopic sinus surgery and recovered uneventfully. Our study shows that even in immunocompetent patients who present with non-resolving or worsening facial pain resembling the original diagnosis of TN, clinicians should remain vigilant for the possibility of alternative underlying pathologies including fungal sinusitis. Full article

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14 pages, 888 KB

Open AccessReview

Otologic and Sinonasal Manifestations of Pediatric Primary Ciliary Dyskinesia: A Scoping Review

by Kenny Nguyen, Noah D. Bogart, Alexa N. Pearce, Lindsay E. Blake, Brendan Sweeney, Vijay A. Patel and Robert A. Saadi

Sinusitis 2026, 10(1), 3; https://doi.org/10.3390/sinusitis10010003 - 28 Jan 2026

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Abstract

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder of motile cilia that leads to impaired mucociliary clearance and recurrent airway infections. Children with PCD often present with ear and sinus disease resembling common pediatric conditions, yet the true burden and management [...] Read more.

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder of motile cilia that leads to impaired mucociliary clearance and recurrent airway infections. Children with PCD often present with ear and sinus disease resembling common pediatric conditions, yet the true burden and management remain incompletely defined. To address this gap, a systematic search for pediatric cohort studies published between 2020 and 2025 reporting otologic and sinonasal features of PCD was performed. Searches of PubMed, Embase, Scopus, and Web of Science identified 12 eligible studies, encompassing 524 children with confirmed PCD. Data extracted focused on demographics, otologic and sinonasal manifestations, vestibular findings, radiographic imaging, and interventions. Across studies, 60.3% had a history of otitis media and 39.1% had hearing loss, predominantly conductive. Tympanostomy tubes were utilized in more than half of patients, with many requiring multiple sets over time due to recurrent effusions or tube occlusion. Sinonasal disease was nearly universal, with 78.5% demonstrating chronic rhinosinusitis and most reporting nasal congestion and rhinorrhea; nasal polyps were uncommonly noted. Vestibular symptoms were also infrequently assessed but present in some patient cohorts. In conclusion, otologic and sinonasal disease are highly co-prevalent in pediatric PCD, highlighting the need for early recognition, regular surveillance, and standardized outcome reporting to guide long-term management of this complex chronic disease. Full article

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25 pages, 339 KB

Open AccessArticle

Sex- and Age-Specific Risk Factors for Asthma: A Comparative Analysis of Demographic, Clinical, and Comorbidity Profiles in Men and Women

by Daniel Lopez-Hernandez, Leticia Brito-Aranda, Karina Ayala-Lopez, Tania Castillo-Cruz, Guadalupe Vanessa Vazquez-Guzman, Maria Clara Hernandez-Almazan, Tabata Gabriela Anguiano-Velazquez, Edgar Cruz-Aviles, Luis Beltran-Lagunes, Christian David Sevilla-Mendoza and Luis Angel Herrerias Colin

Sinusitis 2026, 10(1), 2; https://doi.org/10.3390/sinusitis10010002 - 9 Jan 2026

Viewed by 1937

Abstract

Asthma is a multifactorial respiratory condition affected by demographic, clinical, and lifestyle factors. Recognizing sex-related differences in risk factors may help develop personalized preventive strategies and ultimately enhance clinical outcomes. This study aims to compare the characteristics of male and female patients with [...] Read more.

Asthma is a multifactorial respiratory condition affected by demographic, clinical, and lifestyle factors. Recognizing sex-related differences in risk factors may help develop personalized preventive strategies and ultimately enhance clinical outcomes. This study aims to compare the characteristics of male and female patients with asthma and to identify the primary risk factors linked to the condition in each group as well. A comparative analysis was conducted using regression models to evaluate the association between asthma and potential risk factors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate the strength of associations for men and women separately. In females, obesity (OR, 1.85; 95% CI, 1.24–2.75), chronic obstructive pulmonary disease (COPD) (OR, 3.37; 95% CI, 1.77–6.43), chronic sinusitis (OR, 4.37; 95% CI, 1.02–18.64), and hypothyroidism (OR, 1.79; 95% CI, 1.09–2.94) were significantly associated with asthma. In males, COPD was the strongest predictor (OR, 4.35; 95% CI, 1.18–15.97), while other factors showed weaker or non-significant associations. Age was not a significant predictor in either sex. The findings highlight important sex differences in the risk profile for asthma. These results underscore the need for sex-specific approaches in the prevention, diagnosis, and management of asthma. Full article

13 pages, 561 KB

Open AccessReview

The Effects of Microplastics and Nanoplastics in the Nasal Airway and Upper Respiratory Tract

by Maayan S. Kahan, Benjamin S. Bleier, Mansoor M. Amiji and Alan D. Workman

Sinusitis 2026, 10(1), 1; https://doi.org/10.3390/sinusitis10010001 - 22 Dec 2025

Cited by 1 | Viewed by 2030

Abstract

Environmental microplastic pollution is rising, and the recent literature reflects these conditions primarily by focusing on the effects of microplastics in the human lung and gut region. Despite the specific prevalence of airborne microplastics, the bulk of the existing literature neglects the point [...] Read more.

Environmental microplastic pollution is rising, and the recent literature reflects these conditions primarily by focusing on the effects of microplastics in the human lung and gut region. Despite the specific prevalence of airborne microplastics, the bulk of the existing literature neglects the point of initial contact of microplastics with the human body, namely the upper airway, specifically the nasal region. This review aims to highlight recent findings surrounding the effects of microplastics in the nose in both in vitro and clinical models. Areas of particular interest include changes in cell morphology, microplastic permeation, cytotoxicity, and inflammatory effects. Although permeation and toxicity findings vary across studies, the literature collectively indicates hazards to cellular health and potential impacts on patient quality of life. Full article

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Sinusitis, Volume 10, Issue 1 (June 2026) – 15 articles

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