Advances in Pharmacotherapy for Nasal Disorders in Rhinology

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (30 September 2025) | Viewed by 2596

Special Issue Editor


E-Mail Website
Guest Editor
Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples “Federico II”, 80131 Naples, Italy
Interests: otorhinolaryngology; rhinology; pediatric diseases; molecular medicine; biologics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the last decade, precision medicine and new biologics have revolutionized clinical practice. Every day we face new therapeutic challenges that require a meticulous selection process. This Special Issue aims to provide readers and colleagues with several new therapeutic strategies for the treatment of sinonasal diseases in adults and children. Chronic rhinosinusitis is a widespread and challenging disease affecting about 5% to 12% of the general population, exerting a significant social and economic impact. Depending on the presence or absence of nasal polyps, CRS is divided into two subgroups: chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps. The latter is an inflammatory disease predominantly driven by type 2 inflammation, which is characterized by the upregulation of type 2 cytokines interleukin (IL)-4, IL-13, and IL-5, high concentrations of tissue immunoglobulin (Ig)E, and increased serum IgE. T2 inflammation has been described as a common pathophysiological basis of chronic rhinosinusitis with nasal polyps and several comorbidities such as asthma, allergic rhinitis, atopic dermatitis, etc., which often coexist in the same patient.

Chronic rhinosinusitis is characterized by chronic inflammation in the paranasal sinus, with persistent and debilitating symptoms that include nasal obstruction, hyposmia, or anosmia. Persistent symptoms have a strong negative impact on the patient’s quality of life and productivity compared to other serious chronic diseases. Chronic rhinosinusitis in children is a common condition that is often misdiagnosed and can be challenging to treat. The exact prevalence of pediatric rhinosinusitis is unknown because only a small percentage of cases present to the physician’s office. It is estimated that 6% to 13% of children will have had an episode of rhinosinusitis by 3 years of age.

Pediatric chronic rhinosinusitis can be difficult to accurately diagnose, given multiple possible contributing factors and varying symptoms that can be challenging to ascertain in children. Studies of pediatric chronic rhinosinusitis often focus on select populations of patients with upper respiratory complaints. Comorbidities associated with chronic rhinosinusitis should be carefully assessed in everyday clinical practice, even with the help of new diagnostic technologies, artificial intelligence, and multidisciplinary teams. With the perspective of precision medicine and a multidisciplinary approach, this Special Issue aims to describe not only the new challenges in clinical diagnostics but also to provide therapeutic tools useful in clinical practice to personalize strategies from a patient-centered perspective. Furthermore, the need for an integrated multidisciplinary approach in the evaluation of diseases in the fields of rhinology, otology, laryngology, allergology, immunology, pulmonology, pediatrics, dermatology, gastroenterology, and more cannot be overlooked.

These are the reasons that I proposed this Special Issue to collect articles on "Advances in Pharmacotherapy for Nasal Disorders in Rhinology". Studies should describe the challenges and perspectives in rhinology diagnostics and therapy using basic science, clinical, and population-based approaches.

Dr. Elena Cantone
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. Pharmaceuticals is an international peer-reviewed open access monthly 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 2900 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

  • rhinology
  • CRS
  • asthma
  • nasal polyps
  • biologics
  • airflow
  • children
  • QoL
  • artificial intelligence
  • olfaction
  • chemical senses

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

26 pages, 10088 KB  
Article
Exploring E-Vape Aerosol Penetration into Paranasal Sinuses: Insights from Patient-Specific Models
by Amr Seifelnasr, Farhad Zare, Xiuhua Si and Jinxiang Xi
Pharmaceuticals 2025, 18(2), 142; https://doi.org/10.3390/ph18020142 - 22 Jan 2025
Cited by 1 | Viewed by 2113
Abstract
Background: Acute and chronic sinusitis significantly impact patients’ quality of life. Effective drug delivery to paranasal sinuses is crucial for treating these conditions. However, medications from conventional devices like nasal drops, sprays, and nebulized mists often fail to penetrate the small ostia and [...] Read more.
Background: Acute and chronic sinusitis significantly impact patients’ quality of life. Effective drug delivery to paranasal sinuses is crucial for treating these conditions. However, medications from conventional devices like nasal drops, sprays, and nebulized mists often fail to penetrate the small ostia and reach the sinuses. This study aims to assess the effectiveness of e-vape-generated aerosols entering and filling paranasal sinus cavities, particularly the maxillary sinus. Methods: The aerosol droplets were generated using an electronic vaporizer (e-vape) and were composed solely of vegetable glycerin (VG) and propylene glycol (PG). Patient-specific, transparent nose-sinus models, including one with post-uncinectomy surgery, were used to evaluate the effectiveness of these e-vape-generated VG-PG aerosols in entering the sinuses under unidirectional and bidirectional airflow conditions. Visualizations from various nasal model views and lighting conditions were recorded. Particle size distribution measurements of the e-vape aerosol were conducted using a laser diffraction particle size analyzer. Results: E-vape-generated VG-PG droplets effectively enter paranasal sinuses under specific administration conditions. E-vape aerosol droplet size measurements revealed a mean particle size ranging from 2.895 to 3.359 μm, with a median particle size (D50) averaging 2.963 μm. The speed of aerosol entering the paranasal sinuses is directly proportional to the ostia size; larger ostia result in faster sinus entry. A continuous moderate flow is necessary to gradually fill the paranasal sinus cavities. The aerosol entry into sinuses was observed at 2 L/min and decreased with increasing flow rate. The mechanisms of aerosol entry involve maintaining a positive pressure gradient across the ostial canal, a non-equilibrium transverse pressure distribution, and a two-way flow through the ostium. Gravitational forces and recirculation currents further enhance the deposition of e-vape aerosols. Comparative tests showed that traditional delivery devices exhibited limited penetration into paranasal sinuses. Conclusions: This study demonstrated that e-vape-generated aerosols could serve as a vehicle for delivering active pharmaceutical ingredients (APIs) directly to the paranasal sinuses, improving treatment outcomes. Full article
(This article belongs to the Special Issue Advances in Pharmacotherapy for Nasal Disorders in Rhinology)
Show Figures

Figure 1

Review

Jump to: Research

18 pages, 1059 KB  
Review
Azelastine–Fluticasone Combination Therapy in Allergic Rhinitis: Current Evidence and Clinical Implications in Children and Adults
by Cristiana Indolfi, Angela Klain, Giulio Dinardo, Carolina Grella, Pierluigi Di Filippo, Ilaria Fatica, Vincenzo Napolano, Fabio Decimo and Michele Miraglia del Giudice
Pharmaceuticals 2025, 18(11), 1624; https://doi.org/10.3390/ph18111624 - 28 Oct 2025
Abstract
Allergic rhinitis (AR) is a common chronic respiratory disease that significantly impairs the life of children. While a combination intranasal spray of azelastine hydrochloride and fluticasone propionate (Aze-Flu) is an established effective treatment for adults with moderate-to-severe AR, the clinical evidence available in [...] Read more.
Allergic rhinitis (AR) is a common chronic respiratory disease that significantly impairs the life of children. While a combination intranasal spray of azelastine hydrochloride and fluticasone propionate (Aze-Flu) is an established effective treatment for adults with moderate-to-severe AR, the clinical evidence available in the pediatric population is limited. This review summarizes the current evidence on the efficacy, safety, and impact on Quality of Life (QoL) of Aze-Flu in children. Clinical trials have demonstrated that Aze-Flu provides faster and greater symptom relief in children with AR compared to fluticasone propionate (FP) monotherapy. One randomized controlled trial demonstrated that, although the overall change in the reflective Total Nasal Symptom Score (rTNSS) was not statistically different from the placebo, this was possibly due to rater assessment bias. Children’s symptoms self-assessment showed considerable ameliorations in both nasal and ocular scores. Furthermore, treatment with Aze-Flu has been shown to produce clinically relevant and statistically significant improvements in QoL compared to placebo in children with moderate-to-severe seasonal AR. The safety profile is favorable; a 3-month study confirmed that Aze-Flu is well-tolerated, with an incidence of treatment-related adverse events comparable to that of FP monotherapy. Beyond AR, emerging evidence suggests potential benefits of Aze-Flu in children with adenoid hypertrophy. The available evidence supports Aze-Flu as an effective and well-tolerated therapeutic option for children with moderate-to-severe AR, offering superior and faster symptom control than monotherapy and leading to meaningful improvements in quality of life. Future pediatric trials should incorporate validated, child-specific assessment tools to better capture treatment efficacy. Full article
(This article belongs to the Special Issue Advances in Pharmacotherapy for Nasal Disorders in Rhinology)
Show Figures

Figure 1

Back to TopTop