Sinonasal Disorders: Biomarkers for Diagnosis and Prognosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 5623

Special Issue Editors

Department of Otolaryngology—Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333604, Taiwan
Interests: empty nose syndrome; rhinological disease; sleep science
Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan
Interests: rhinology; ENT; endoscopic surgery; pediatric otolaryngology

Special Issue Information

Dear Colleagues,

Despite rapid progress of medicine, the prevalence of sinonasal disorders remains high and has a significant impact on the global economy in the modern era. Sinonasal disorders, such as acute/chronic rhinosinusitis, nasal polyposis, allergic/nonallergic rhinitis, empty nose syndrome, etc., frequently cause physical, sleep, and even psychiatric illness. Acting as a gatekeeper of the entire airway, early detection and control of diseases in the sinonasal airway deserve further attention.

Biomarkers, including serum, tissue, lavage fluid, airborne, and image markers as tools for early detection or diagnosis, treatment response, and surgical prognosis, are required to play a role in endotyping for precision medicine. Consequently, novel biomarkers with easy availability and provide practical information about precise prognosis and likely response to medical or surgical therapy are pivotal.

On account of the great advances in the molecular and pathophysiological understanding of complex sinonasal disorders, the relevance of biomarkers for the early detection and direction of treatment strategies has attracted a great deal of attention. This Special Issue will address current advances in biomarkers for sinonasal disorders.

Dr. Ta-Jen Lee
Dr. Chia-Hsiang Fu
Guest Editors

Manuscript Submission Information

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Keywords

  • biomarker
  • sinonasal disorder
  • rhinosinusitis
  • nasal polyposis
  • allergic rhinitis
  • empty nose syndrome
  • nonallergic rhinitis
  • diagnosis
  • prognosis
  • surgery

Published Papers (3 papers)

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Research

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9 pages, 3527 KiB  
Article
Computational Fluid Dynamics Could Enable Individualized Surgical Treatment of Nasal Obstruction (A Preliminary Study)
by Marek Plášek, Michaela Masárová, Marián Bojko, Pavel Komínek, Petr Matoušek and Martin Formánek
Diagnostics 2022, 12(11), 2642; https://doi.org/10.3390/diagnostics12112642 - 31 Oct 2022
Cited by 2 | Viewed by 1361
Abstract
Passage of nasal airflow during breathing is crucial in achieving accurate diagnosis and optimal therapy for patients with nasal disorders. Computational fluid dynamics (CFD) is the dominant method for simulating and studying airflow. The present study aimed to create a CFD nasal airflow [...] Read more.
Passage of nasal airflow during breathing is crucial in achieving accurate diagnosis and optimal therapy for patients with nasal disorders. Computational fluid dynamics (CFD) is the dominant method for simulating and studying airflow. The present study aimed to create a CFD nasal airflow model to determine the major routes of airflow through the nasal cavity and thus help with individualization of surgical treatment of nasal disorders. The three-dimensional nasal cavity model was based on computed tomography scans of the nasal cavity of an adult patient without nasal breathing problems. The model showed the main routes of airflow in the inferior meatus and inferior part of the common meatus, but also surprisingly in the middle meatus and in the middle part of the common nasal meatus. It indicates that the lower meatus and the lower part of the common meatus should not be the only consideration in case of surgery for nasal obstruction in our patient. CFD surgical planning could enable individualized precise surgical treatment of nasal disorders. It could be beneficial mainly in challenging cases such as patients with persistent nasal obstruction after surgery, patients with empty nose syndrome, and patients with a significant discrepancy between the clinical findings and subjective complaints. Full article
(This article belongs to the Special Issue Sinonasal Disorders: Biomarkers for Diagnosis and Prognosis)
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10 pages, 1030 KiB  
Article
Identifying Obstructive Sleep Apnoea in Patients with Empty Nose Syndrome
by Chien-Chia Huang, Pei-Wen Wu, Chi-Cheng Chuang, Cheng-Chi Lee, Yun-Shien Lee, Po-Hung Chang, Chia-Hsiang Fu, Chi-Che Huang and Ta-Jen Lee
Diagnostics 2022, 12(7), 1720; https://doi.org/10.3390/diagnostics12071720 - 15 Jul 2022
Viewed by 1590
Abstract
Obstructive sleep apnoea (OSA) is characterised by repetitive episodes of upper airway collapse and breathing cessation during sleep. Empty nose syndrome (ENS) is a surgically iatrogenic phenomenon of paradoxical nasal obstruction despite an objectively patent nasal airway. This study aimed to investigate sleep [...] Read more.
Obstructive sleep apnoea (OSA) is characterised by repetitive episodes of upper airway collapse and breathing cessation during sleep. Empty nose syndrome (ENS) is a surgically iatrogenic phenomenon of paradoxical nasal obstruction despite an objectively patent nasal airway. This study aimed to investigate sleep quality and the presence of OSA in ENS patients. Forty-eight ENS patients underwent full-night polysomnography. Total nasal resistance (TNR) was determined using anterior rhinomanometry. Symptoms and quality of life were evaluated by the empty nose syndrome 6-item questionnaire (ENS6Q), Sino-Nasal Outcome Test-22 (SNOT-22), and Epworth Sleepiness Scale questionnaires (ESS). Fourteen, twelve, and fourteen patients had mild, moderate, and severe OSA, respectively. The apnoea–hypopnoea index (AHI) and the lowest SpO2 were 23.8 ± 22.4/h and 85.9 ± 11.1%, respectively. N1, N2, N3 and rapid-eye-movement sleep comprised 30.2 ± 16.9%, 47.3 ± 15.5%, 2.1 ± 5.4%, and 20.0 ± 8.1% of the total sleep time. Body mass index, neck circumference, serum total immunoglobulin E, and ENS6Q score were significantly associated with AHI in the regression analysis. The ENS6Q scores correlated positively with AHI, arousal index, and ESS score, but negatively with TNR. ENS patients showed a high OSA prevalence and significant sleep impairment. The extent of OSA was associated with obesity levels and ENS symptom severity. The ENS6Q scores correlated negatively with nasal resistance, and positively with arousal frequency and daytime sleepiness. The recognition of individuals experiencing marked OSA and provision of appropriate intervention is critical to preventing long-term morbidity and mortality, and improving therapeutic outcomes in ENS patients. Full article
(This article belongs to the Special Issue Sinonasal Disorders: Biomarkers for Diagnosis and Prognosis)
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Review

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19 pages, 736 KiB  
Review
The Diagnostic and Prognostic Role of Biomarkers in Chronic Rhinosinusitis
by Jun Jie Seah, Mark Thong and De Yun Wang
Diagnostics 2023, 13(4), 715; https://doi.org/10.3390/diagnostics13040715 - 14 Feb 2023
Cited by 4 | Viewed by 2204
Abstract
Chronic rhinosinusitis (CRS) refers to an inflammatory disease of the sinonasal mucosa, with a significant economic burden and impact on quality of life. The diagnosis of CRS is conventionally made on careful history and physical examination, including nasoendoscopic assessment which requires technical expertise. [...] Read more.
Chronic rhinosinusitis (CRS) refers to an inflammatory disease of the sinonasal mucosa, with a significant economic burden and impact on quality of life. The diagnosis of CRS is conventionally made on careful history and physical examination, including nasoendoscopic assessment which requires technical expertise. There has been increasing interest in using biomarkers in the non-invasive diagnosis and prognostication of CRS, tailored to the disease inflammatory endotype. Potential biomarkers currently being studied can be isolated from peripheral blood, exhaled nasal gases or nasal secretions, as well as sinonasal tissue. In particular, various biomarkers have revolutionized the way in which CRS is managed, revealing new inflammatory pathways where novel therapeutic drugs are employed to curb the inflammatory process, which may be different from one patient to the next. Biomarkers that have been extensively studied in CRS, such as eosinophil count, IgE, and IL-5, have been associated with a TH2 inflammatory endotype which correlates with an eosinophilic CRSwNP phenotype that predicts a poorer prognosis, tends to recur after conventional surgical treatment, but responds to glucocorticoid treatment. Newer biomarkers that demonstrate potential, such as nasal nitric oxide, can support a diagnosis of CRS with or without nasal polyps, especially when invasive tests such as nasoendoscopy are unavailable. Other biomarkers such as periostin can be used to monitor disease course after treatment of CRS. With a personalized treatment plan, the management of CRS can be individualized, optimizing treatment efficiency and reducing adverse outcomes. As such, this review aims to compile and summarize the existing literature regarding the utility of biomarkers in CRS in terms of diagnosis and prognostication, and also makes recommendations for further studies to fill current knowledge gaps. Full article
(This article belongs to the Special Issue Sinonasal Disorders: Biomarkers for Diagnosis and Prognosis)
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