Sinusitis, Volume 3, Issue 2 (June 2018) – 4 articles

Bitter (T2R) and sweet (T1R) taste receptors are expressed in the upper airway, where they play key roles in antimicrobial innate immune defense. Bitter bacterial products are detected by taste receptors on ciliated cells and solitary chemosensory cells, resulting in downstream nitric oxide and antimicrobial peptide release, respectively. Genetic polymorphisms in taste receptors contribute to variations in T1R and T2R functionality, and phenotypic differences correlate with disease status and disease severity in chronic rhinosinusitis (CRS). Correspondingly, there are also subjective bitter and sweet taste differences between patients with CRS and individuals without CRS across a number of compounds. The ability to capture these differences with a simple and inexpensive taste test provides a potentially useful diagnostic tool, while bitter compounds themselves could potentially serve as therapeutic agents. The present review examines the physiology of airway taste receptors and the recent literature elucidating the role taste receptors play in rhinologic disease. Full article

The literature strongly recommends the use of oral corticosteroids in the management of patients with eosinophilic chronic rhinosinusitis (CRS) with nasal polyps. Although potential complications associated with the long-term use of oral corticosteroids for the treatment of CRS have been suggested, no studies have described these effects in detail. Forty-three patients with a mean age of 51 years with eosinophilic CRS were retrospectively evaluated after surgery. Short-course oral prednisolone (PSL, 0.5 mg/kg of body weight) was provided for one week when anosmia and eosinophilic mucin and/or nasal polyps were present. The postoperative follow-up period ranged from 12 to 108 months (average: 62 months). HbA1C showed normal ranges in all except one patient, who had a diabetic pattern of HbA1C of 6.5%. Five patients had serum cortisol levels below the cutoff value. However, re-examination of the serum cortisol and adrenocorticotropic hormone stimulation test showed normal ranges in all five patients who had initially shown abnormal values of serum cortisol. Thus, adrenal insufficiency in all the patients was negligible. Five (3 women and 2 men) out of the 15 patients (6 women and 9 men) who participated in bone mineral density measurement showed significant reductions, suggesting the presence of osteoporosis. Patients taking long-term and repeated short-course use of oral corticosteroids for refractory nasal polyps of eosinophilic CRS are likely to have a potentially increased risk for osteoporosis. Full article

Pediatric chronic rhinosinusitis is a common condition amongst pediatric patients. Despite its prevalence, debate continues regarding the best treatment strategies. The current paper examines the literature as it pertains to the surgical management of pediatric chronic rhinosinusitis. Adenoidectomy remains the mainstay in the initial surgical management. Both maxillary sinus irrigation and balloon dilation of the sinuses have been studied with disagreement as to the timing and patient selection for those procedures. Functional endoscopic sinus surgery is an accepted treatment modality, especially in initial surgical failures. Further studies will be needed to better delineate patient selection and timing of specific surgical techniques. Full article

Rhinosinusitis and asthma are two comorbid conditions that lead to pathological and clinical diseases affecting the respiratory tract. They are connected by significant anatomical, epidemiological, pathophysiological, and clinical evidence, and also share therapeutic principles. The aim of this review is to provide an updated overview of the existing link between rhinosinusitis and asthma focusing on the pediatric age. Full article