Sinusitis

10 pages, 1563 KiB

Open AccessArticle

The Effect of the COVID-19 Pandemic on Trends of Complicated Sinusitis in Western Australia

by William Crohan, Phillip Sale and Shyan Vijayasekaran

Sinusitis 2025, 9(1), 7; https://doi.org/10.3390/sinusitis9010007 - 9 Apr 2025

The possible association between COVID-19 and the development of complicated sinusitis in paediatric populations was noted during the COVID-19 pandemic, but understanding of this disease process is still developing. In Perth, Western Australia, a distinctive state of isolation, vaccination status and thorough screening [...] Read more.

The possible association between COVID-19 and the development of complicated sinusitis in paediatric populations was noted during the COVID-19 pandemic, but understanding of this disease process is still developing. In Perth, Western Australia, a distinctive state of isolation, vaccination status and thorough screening methodology led to a unique experience of the pandemic. We conducted a retrospective cohort study of 129 patients admitted to Perth Children’s Hospital from May 2018 to September 2024. Disease factors were studied, including clinical severity, procedure, COVID status, length of stay and inflammatory markers. A surge in patients was noted during the COVID-19 pandemic, with at least 16 having a concurrent diagnosis of COVID-19 at the time of admission. The study demonstrates that whilst COVID-19 infection was associated with the development of complicated sinusitis, it was not associated with increased severity of disease or an increased likelihood of requiring surgical management. A unique subset of patients emerged with unusual presentations, possibly representing a new disease process of suppurative dacryoadenitis. Full article

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15 pages, 694 KiB

Open AccessReview

Utility of Nasal Debridement Following Pediatric Functional Endoscopic Sinus Surgery: A Scoping Review

by Jeeho D. Kim, Bastien A. Valencia-Sanchez, Beau Hsia, Saif A. Alshaka, Gabriel Bitar and Vijay A. Patel

Sinusitis 2025, 9(1), 6; https://doi.org/10.3390/sinusitis9010006 - 9 Apr 2025

Abstract

The role of second-look endoscopy and debridement (SLED) remains uncertain in children due to the perceived need for additional general anesthesia following their initial functional endoscopic sinus surgery (FESS) while mitigating risks and healthcare costs. This comprehensive review synthesizes current evidence on SLED [...] Read more.

The role of second-look endoscopy and debridement (SLED) remains uncertain in children due to the perceived need for additional general anesthesia following their initial functional endoscopic sinus surgery (FESS) while mitigating risks and healthcare costs. This comprehensive review synthesizes current evidence on SLED in children, focusing on its practice pattern and treatment outcomes. This review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Protocol. Independent queries of the PubMed Central, MEDLINE, and Bookshelf databases were performed. A total of 53 relevant, unique articles were initially identified; 12 articles were ultimately deemed appropriate for inclusion in final analysis. The most common indication for FESS was chronic rhinosinusitis or recurrent sinus infections while that for SLED under general anesthesia varied from institutional practice patterns to surgeon preference. No meaningful comparison of outcomes was possible as the “success rates” of FESS with or without SLED were largely based on unvalidated questionnaires and equally subjective surgeon assessments. Even when looking at outcomes based on revision rates, FESS with SLED was considered successful between 60.5% and 95.6% of the time, with a mean of 84.2%, while FESS without SLED was successful between 71.0% to 96.4% of the time, with a mean of 86.3%. However, no randomized, controlled studies were available in the pediatric literature pertaining to FESS with or without SLED. Moreover, it became apparent that previous conclusions on the utility of SLED were based on the outcomes of FESS following one single SLED under general anesthesia vs. no SLED. As such, there is an unmet need to examine the utility of serial, office-based SLED in children to better elucidate its utility in pediatric FESS. Full article

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8 pages, 606 KiB

Open AccessBrief Report

Association Between Staphylococcal Enterotoxin-Specific IgE and House-Dust-Mite-Specific IgE in Brazilian Patients with Chronic Rhinosinusitis with Nasal Polyps

by Priscilla Campos, Sérgio Duarte Dortas Junior, Solange Oliveira Rodrigues Valle, Nathalia Novello Ferreira, Fabiana Chagas da Cruz, Priscila Novaes Ferraiolo and José Elabras Filho

Sinusitis 2025, 9(1), 5; https://doi.org/10.3390/sinusitis9010005 - 18 Mar 2025

Abstract

Chronic Rhinosinusitis (CR) is a common inflammatory condition with complex pathophysiology involving multiple interleukins. In times of precision medicine, it is mandatory to cluster our patients to offer the best tailored treatment with the lowest cost possible. Therefore, some triage markers can be [...] Read more.

Chronic Rhinosinusitis (CR) is a common inflammatory condition with complex pathophysiology involving multiple interleukins. In times of precision medicine, it is mandatory to cluster our patients to offer the best tailored treatment with the lowest cost possible. Therefore, some triage markers can be used towards this goal, without raising much financial burden. The aim of this study was to identify the association of staphylococcal enterotoxin (SE)-specific IgE of types A, B, C, and TSST-1 (toxic shock syndrome toxin-1); and total IgE (tIgE) and specific IgE for Dermatophagoides pteronyssinus (DP), Dermatophagoides farinae (DF), and Blomia tropicalis (BT) in Brazilian patients with CRSwNP. Thirty-six patients with CSRwNP were analyzed for serum IgE levels: tIgE and specific IgE for: DP, DF, BT, and SE types A, B, C, TSST-1 by ImmunoCAP^®. The mean value of tIgE in SE-specific IgE-positive patients was 767 IU/mL and in house-dust-mite (HDM)-positive patients, the mean tIgE was 319 IU/mL (p < 0.005). A total of 86% of patients who had high tIgE levels but were SE-specific IgE-negative had positive specific IgE for at least one of the HDMs tested. The Fisher exact test statistic value for this association was significant (p < 0.05/p = 0.014). We found an association between high levels of tIgE and SE-specific IgE in patients with CRSwNP, possibly related to local and peripheric polyclonal IgE production. The mean value of tIgE—with a suggested cutoff point of tIgE levels of 767 IU/mL—can be used as a triage biomarker for positive SE-specific IgE in CRSwNP patients. Full article

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8 pages, 4343 KiB

Open AccessCase Report

Unmasking the Fungal Menace: A Case Report of Chronic Granulomatous Invasive Fungal Sinusitis of Maxilla

by Swathi Krishna, Vivekanand Ashok, Shahseena Abdulla, Rosmy John and Prathap Ramalingam

Sinusitis 2025, 9(1), 4; https://doi.org/10.3390/sinusitis9010004 - 12 Feb 2025

Abstract

Chronic granulomatous invasive fungal sinusitis (CGIFS) is an uncommon type of invasive sinusitis that is characteristically seen in immunocompetent individuals. Common clinical manifestations of this condition include proptosis, cheek swelling, and headache. The pathogenic organism is Aspergillus in the majority of reported cases. [...] Read more.

Chronic granulomatous invasive fungal sinusitis (CGIFS) is an uncommon type of invasive sinusitis that is characteristically seen in immunocompetent individuals. Common clinical manifestations of this condition include proptosis, cheek swelling, and headache. The pathogenic organism is Aspergillus in the majority of reported cases. Diagnosis is made by histopathological and microbiological examination of tissue specimens. Due to its expansible nature, bone erosion is also associated with this condition. Treatment is surgical clearance/debulking followed by long-term antifungal therapy. Here, we report the case of a 31-year-old male presented with right-side cheek swelling. The patient underwent a medial maxillectomy and was diagnosed with CGIFS. The patient was put on oral voriconazole for 3 months. To conclude, CGIFS is a rare variant of invasive fungal sinusitis that may mimic malignancy or granulomatous diseases such as tuberculosis, rhinoscleroma, and syphilis. Accurate diagnosis is of utmost importance in providing management for CGIFS. Full article

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4 pages, 153 KiB

Open AccessCommentary

The Impact of Churg–Strauss Syndrome on Nasal Function and Quality of Life: An Underexplored Dimension

by Luca Galassi and Federica Facchinetti

Sinusitis 2025, 9(1), 3; https://doi.org/10.3390/sinusitis9010003 - 30 Jan 2025

Abstract

Eosinophilic Granulomatosis with Polyangiitis (EGPA)/Churg–Strauss syndrome is a systemic vasculitis that often causes chronic nasal dysfunction, including anosmia, nasal obstruction, and sinusitis. Anosmia, affecting up to 20% of EGPA patients, has a significant negative impact on quality of life (QoL). The loss of [...] Read more.

Eosinophilic Granulomatosis with Polyangiitis (EGPA)/Churg–Strauss syndrome is a systemic vasculitis that often causes chronic nasal dysfunction, including anosmia, nasal obstruction, and sinusitis. Anosmia, affecting up to 20% of EGPA patients, has a significant negative impact on quality of life (QoL). The loss of smell disrupts daily activities, reduces enjoyment of food, and impairs social interactions, leading to feelings of isolation, depression, and anxiety. These psychosocial consequences, combined with persistent physical symptoms, contribute to a marked decline in overall well-being and are among the strongest predictors of poor QoL in EGPA patients. Early diagnosis and intervention are essential to mitigate these effects and improve patient outcomes. A multidisciplinary approach that combines pharmacological treatment, surgical options, and psychosocial support is critical to managing both the physical and emotional challenges of nasal dysfunction in EGPA. However, further research is needed to explore long-term management strategies, optimize therapeutic approaches, and better address the complex interplay between physical symptoms and QoL in EGPA patients. Full article

5 pages, 1322 KiB

Open AccessCase Report

Sinonasal Mass in the Setting of Prior Maxillofacial Surgery and Solid Organ Malignancy

by Yihuai Qu, Jeffrey C. Mecham and Michael J. Marino

Sinusitis 2025, 9(1), 2; https://doi.org/10.3390/sinusitis9010002 - 25 Jan 2025

Abstract

Fungal rhinosinusitis (FRS) can be classified into invasive and non-invasive forms, with the fungal ball (FB) representing a common non-invasive type with generally favorable outcomes post-operatively. The clinical presentation of FB can vary and be non-specific, and it is important to consider a [...] Read more.

Fungal rhinosinusitis (FRS) can be classified into invasive and non-invasive forms, with the fungal ball (FB) representing a common non-invasive type with generally favorable outcomes post-operatively. The clinical presentation of FB can vary and be non-specific, and it is important to consider a wide differential diagnosis for sinonasal masses, including malignancy. We present the case of a 74-year-old female presenting with a two-year history of nasal obstruction and drainage. She has a history of breast cancer and prior maxillomandibular surgery, and imaging showed a poorly defined mass in the right maxillary sinus with possible hemorrhagic and/or proteinaceous content. Rigid nasal endoscopy revealed a friable mass, and endoscopic sinus surgery findings were consistent with FB. This case exemplifies the need to consider a broad set of differential diagnoses when evaluating sinonasal masses, especially if the patient has a prior malignancy or maxillomandibular surgical history, including FB and metastases to the paranasal sinuses. Given the presence of non-specific symptoms, it is important to consider early imaging for patients with distorted anatomy and a history of malignancy. Endoscopic sinus surgery, with high success rates, is the gold-standard treatment for FB. Full article

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8 pages, 3460 KiB

Open AccessCase Report

Odontogenic Sinusitis of Endodontic Origin: Successful Management Through Endodontic Treatment

by Marcelo Rolla, Karem Paula Pinto, Luciana Moura Sassone and Emmanuel João Nogueira Leal Silva

Sinusitis 2025, 9(1), 1; https://doi.org/10.3390/sinusitis9010001 - 9 Jan 2025

Abstract

Odontogenic sinusitis is a maxillary sinus infection arising from dental pathology, primarily involving posterior maxillary teeth due to their anatomical proximity to the sinus floor. Endodontic infections are a significant etiological factor, yet the condition is frequently underdiagnosed due to its overlapping presentation [...] Read more.

Odontogenic sinusitis is a maxillary sinus infection arising from dental pathology, primarily involving posterior maxillary teeth due to their anatomical proximity to the sinus floor. Endodontic infections are a significant etiological factor, yet the condition is frequently underdiagnosed due to its overlapping presentation with sinonasal sinusitis. The present cases illustrate the diagnosis, management, and outcomes of maxillary sinusitis of endodontic origin through endodontic interventions. Two patients with histories of recurrent maxillary sinusitis underwent dental evaluations after conventional medical therapies failed. Cone-beam computed tomography confirmed the dental etiology in all cases, identifying inadequately treated second mesiobuccal (MB2) canals or significant periapical pathology. Endodontic retreatments were employed to address the underlying dental causes, followed by resolution of sinus symptoms within days. Follow-up imaging demonstrated ongoing bone healing and resolution of sinus involvement. These cases underscore the importance of addressing the dental etiology in maxillary sinusitis of endodontic origin to achieve complete symptom resolution and minimize recurrence. Cone-beam computed tomography proved instrumental in diagnosing and planning treatment, enabling precise management of periapical and sinus conditions. The cases highlight the necessity of a multidisciplinary approach, involving dental and medical professionals, to optimize outcomes. Full article

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4 pages, 859 KiB

Open AccessCase Report

A Single-Stage Procedure for Correction of Silent Sinus Syndrome: A Case Report About Our Experience

by Aurelio D’Ecclesia, Stefano Patruno, Christian Fiorentino and Lazzaro Cassano

Sinusitis 2024, 8(2), 68-71; https://doi.org/10.3390/sinusitis8020009 - 3 Dec 2024

Abstract

Silent sinus syndrome is a rare condition characterized by an almost always unilateral collapse of the maxillary sinus. The most characteristic symptom of this syndrome is enophthalmos. Naso-sinusal disorders are rarely associated with this condition. We are going to discuss a case that [...] Read more.

Silent sinus syndrome is a rare condition characterized by an almost always unilateral collapse of the maxillary sinus. The most characteristic symptom of this syndrome is enophthalmos. Naso-sinusal disorders are rarely associated with this condition. We are going to discuss a case that was associated with recurrent sinusitis. In this case report, we describe how we managed this rare syndrome so we can share our experience with those colleagues that may face this condition. Full article

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5 pages, 1378 KiB

Open AccessCase Report

Recurrent Nasal Polyposis and Bifid Epiglottis in a Child with Bardet–Biedl Syndrome Ciliopathy

by Natalia Fourla, Nikolaos Drimalas and Ioannis Michael Vlastos

Sinusitis 2024, 8(2), 63-67; https://doi.org/10.3390/sinusitis8020008 - 14 Nov 2024

Abstract

Bardet–Biedl syndrome (BBS) is a genetic disease caused by mutations of the BBS genes that encode proteins involved in cilia functioning. It can present with major and/or minor clinical manifestations, such as rod–cone dystrophy, polydactyly, obesity, speech delay, anosmia, congenital heart disease and [...] Read more.

Bardet–Biedl syndrome (BBS) is a genetic disease caused by mutations of the BBS genes that encode proteins involved in cilia functioning. It can present with major and/or minor clinical manifestations, such as rod–cone dystrophy, polydactyly, obesity, speech delay, anosmia, congenital heart disease and genital and renal abnormalities. Diagnosis of this rare disease is based on clinical criteria and can be confirmed with molecular genetic testing. Although BBS is a ciliopathy, nasal polyposis has never before been reported in patients with this condition. This article presents the case of a 12-year-old male patient admitted with symptoms of retinopathy, development delay, anosmia, bifid epiglottis and recurrent nasal polyposis. After several clinical, imaging and genetic examinations, the patient was diagnosed with BBS. His nasal symptoms were treated with functional endoscopic sinus surgery and long-term antibiotic therapy, whereas courses of topical antibiotics as well as topical and systemic corticosteroids had no effect. As a conclusion, it is a rare case that presents new clinical manifestations (nasal polyps) that can be related to BBS and possible effective treatments. Full article

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12 pages, 486 KiB

Open AccessSystematic Review

The Association of Sinusitis with Central Skull Base Osteomyelitis: A Systematic Review

by Owen Tsung Wen Ho and Alex Chengyao Tham

Sinusitis 2024, 8(2), 51-62; https://doi.org/10.3390/sinusitis8020007 - 30 Oct 2024

Abstract

We aim to provide an updated and comprehensive review of the current literature on the clinical profile and treatment options of CSBO caused by sinusitis. Three databases, Pubmed, Embase and Scopus, were searched from inception until 2 October 2022. Titles and abstracts were [...] Read more.

We aim to provide an updated and comprehensive review of the current literature on the clinical profile and treatment options of CSBO caused by sinusitis. Three databases, Pubmed, Embase and Scopus, were searched from inception until 2 October 2022. Titles and abstracts were used for the first stage of study selection; subsequently, full texts were screened for final inclusion. Nine studies were included, with eight case reports and one case series. Patients ranged between 33 and 75 years old, with four females and four males total in the case reports. In the case series, there were 14 patients with a mean age of 62 years old. Patients with CSBO secondary to sinusitis often present with non-specific symptoms which may mimic other pathologies of the head and neck. A high index of suspicion for CSBO is important in the presence of an unremitting headache or cranial nerve palsy. Treatment options include culture-directed long-term antibiotics and surgery. The role of surgery in these patients, however, needs to be investigated more thoroughly. We believe that more large-cohort observational studies assessing the association between sinusitis and CSBO should be performed to further analyze and evaluate this topic. Full article

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14 pages, 1191 KiB

Open AccessReview

What We Know about Nasal Polyposis: The Clinician’s Point of View

by Philippe Eloy and Gabriela Cornelia Musat

Sinusitis 2024, 8(2), 37-50; https://doi.org/10.3390/sinusitis8020006 - 26 Sep 2024

Abstract

Nasal polyposis is defined as a Th2-driven chronic inflammation of the nose and sinus with polyps visible in the nasal fossae. It is a prevalent disease with a significant impact on health-related quality of life (HRQL). Allergies, allergic rhinitis, asthma, and aspirin intolerance [...] Read more.

Nasal polyposis is defined as a Th2-driven chronic inflammation of the nose and sinus with polyps visible in the nasal fossae. It is a prevalent disease with a significant impact on health-related quality of life (HRQL). Allergies, allergic rhinitis, asthma, and aspirin intolerance are frequently associated. The management is individual. The first line of treatment is long-term treatment with intranasal corticosteroids. Oral corticosteroids should be used with caution. When the medical treatment fails, the patient is eligible for sinus surgery, which usually consists of a complete sphenoethmoidectomy. In the case of symptomatic recurrence after both medical and surgical treatment, biologics are currently a very promising treatment effective on all respiratory tracts. Dupilumab is considered in the literature to be the molecule of choice. However, besides the international guidelines published by EPOS and Euforea, the molecule prescribed depends also on its availability in each country and the criteria edited by the health authorities to receive reimbursement. Traditional medical treatment remains necessary as a complement to biologics. At the moment, there is no consensus on when the medical treatment can be stopped. Full article

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9 pages, 5898 KiB

Open AccessArticle

Technical Quality of Contemporary Endoscopic Sinus Surgery: An Assessment by Study of Anatomical Features Needing Attention at Revision Surgery

by Nitish Kumar, Pedro Lanca Gomes, Michael J. Marino, Amar Miglani and Devyani Lal

Sinusitis 2024, 8(2), 28-36; https://doi.org/10.3390/sinusitis8020005 - 14 Aug 2024

Abstract

Although technical causes of endoscopic sinus surgery (ESS) failure have long been reported, we were curious about the quality of contemporary sinus surgery. The electronic health database of Mayo Clinic, Arizona was scrutinized to identify adult patients with diffuse chronic rhinosinusitis (CRS) who [...] Read more.

Although technical causes of endoscopic sinus surgery (ESS) failure have long been reported, we were curious about the quality of contemporary sinus surgery. The electronic health database of Mayo Clinic, Arizona was scrutinized to identify adult patients with diffuse chronic rhinosinusitis (CRS) who underwent revision ESS between January 2019 and September 2023 with a history of bilateral full-house ESS. Anatomical features on preoperative radiology and intraoperative endoscopy were cataloged: residual uncinate tissue, maxillary antrostomy with a non-incorporated natural os, residual ethmoidal septations (three septations > 3 mm), and inadequate sphenoid osteotomy (os size < 6 mm). Sixty-nine subjects were identified. A deviated nasal septum was present in 53.6%. Residual uncinate tissue was noted in 50.7% of patients associated with missed natural maxillary os in 39.13% of antrostomies. An inadequate os diameter was noted in 63.8% of sphenoidotomies. Significant residual septations were seen in posterior ethmoidal cells in 66.7% and anterior ethmoidal cells in 62.3% of patients. Residual frontoethmoidal cells were noted in 72.4% of patients. Although the extent of ESS must be individualized, a high prevalence of features reflecting suboptimal surgery that could limit the success of ESS was identified. These findings merit further consideration for focused training during residency and continuous professional development activities. Full article

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8 pages, 201 KiB

Open AccessArticle

Radiological Assessment of Centrally Limited Sinus Disease in Allergic and Non-Atopic Chronic Rhinosinusitis

by Ahda Farhah Mohd Kutubudin, Aneeza W. Hamizan, Kew Thean Yean, Farah Dayana Zahedi, Baharudin Abdullah and Salina Husain

Sinusitis 2024, 8(2), 20-27; https://doi.org/10.3390/sinusitis8020004 - 1 Aug 2024

Abstract

Background: A centrally limited radiological pattern, marked by mucosal thickening in the central sinonasal cavity with relatively unaffected surrounding sinuses, has been linked to allergy in chronic rhinosinusitis (CRS). However, a comparison between allergic and non-atopic CRS patients is lacking. The role of [...] Read more.

Background: A centrally limited radiological pattern, marked by mucosal thickening in the central sinonasal cavity with relatively unaffected surrounding sinuses, has been linked to allergy in chronic rhinosinusitis (CRS). However, a comparison between allergic and non-atopic CRS patients is lacking. The role of anatomical variations in the ostiomeatal complex also remains unclear. Methods: Adult CRS patients with allergic rhinitis, asthma, eczema, and positive allergy tests were recruited. CRS patients without atopic disease and negative allergy tests were controls. CT scans were evaluated for the centrally limited radiologic pattern. Anatomical variations in the ostiomeatal complex were also examined. Results: The study included 15 allergic CRS and 17 non-atopic CRS participants. Allergic CRS patients showed a higher prevalence of centrally limited sinus disease compared to non-atopic CRS patients (50% vs. 14.7%, p < 0.01). No anatomical variations were conclusively linked to allergy status or the centrally limited sinus disease. Conclusion: Centrally limited sinus disease on radiology is associated with underlying allergy in CRS but should not be the primary diagnostic tool. Anatomical variants did not clearly relate to allergy status or the radiologic pattern but this requires further studies. Full article

7 pages, 208 KiB

Open AccessArticle

Contemporary Update on the Microbiology of Paranasal Sinusitis

by Margaret B. Mitchell, Alan D. Workman, Richard Lu and Neil Bhattacharyya

Sinusitis 2024, 8(2), 13-19; https://doi.org/10.3390/sinusitis8020003 - 16 Jul 2024

Abstract

Background: Sinusitis, whether acute or chronic, is likely due at least in part to disruptions in the microbiota of the paranasal sinuses. Sinus cultures are often employed to guide medical treatment. Objective: To quantify the contemporary microbiology of the paranasal sinuses and better [...] Read more.

Background: Sinusitis, whether acute or chronic, is likely due at least in part to disruptions in the microbiota of the paranasal sinuses. Sinus cultures are often employed to guide medical treatment. Objective: To quantify the contemporary microbiology of the paranasal sinuses and better understand the utility of paranasal sinus cultures. Methods: We identified patients from 2018 to 2019 with sinus cultures taken by an otolaryngologist in the outpatient setting in our healthcare system with a concurrent diagnosis of acute or chronic rhinosinusitis. These cultures were analyzed based on their culture type and result. The most commonly isolated bacteria were further analyzed by species; Staphylococcus resistance patterns were analyzed as well. Results: A total of 2302 culture samples were collected: 2012 (87%) bacterial, 287 (13%) fungal, and 3 (0.1%) mycobacterial cultures. The results of more than half (1142, 57%) of these bacterial cultures were positive for a named genus, while those of 592 (29%) were positive for normal sinus flora and 16 (0.8%) for normal oral flora, and those of 183 (9%) showed no growth. The results of another 79 (4%) bacterial cultures were positive for unnamed bacteria, which were not further classified (e.g., Gram-negative rods). Of the positive bacterial cultures with named genera, the most common genera identified was Staphylococcus (383, 34%). Of these, the most common species of Staphylococcus was S. aureus (311, 81%), 42 of which (14%) showed methicillin resistance (MRSA). Of the fungal cultures, 265 (92%) resulted in no growth, and all three mycobacterial cultures showed no growth. Conclusions: In contrast to fungal cultures, the majority (57%) of sinus bacterial cultures showed positive results, with the identification of a named genus, highlighting the potential utility of this assay in guiding medical therapy. Full article

2 pages, 154 KiB

Open AccessEditorial

Nasal Cytology in Eosinophilic Granulomatosis with Polyangiitis

by David Longhino, Arianna Aruanno and Eleonora Nucera

Sinusitis 2024, 8(2), 11-12; https://doi.org/10.3390/sinusitis8020002 - 29 Jun 2024

Abstract

In recent years, nasal cytology (NC) has become a valuable diagnostic tool in rhinology due to its easy practicability, non-invasiveness, and low cost [...] Full article

10 pages, 230 KiB

Open AccessReview

Eosinophilic Cationic Protein and Immunoglobulin E: Unraveling Biomarkers in Chronic Pediatric Cough

by Snezhina Lazova, Kremena Naydenova and Tsvetelina Velikova

Sinusitis 2024, 8(1), 1-10; https://doi.org/10.3390/sinusitis8010001 - 27 Feb 2024

Abstract

Although the cough reflex is one of the essential protective mechanisms in the respiratory tract, it is considered a considerable health problem in adults and children when it becomes chronic and hypersensitive. However, the need for biomarkers for chronic cough in children and [...] Read more.

Although the cough reflex is one of the essential protective mechanisms in the respiratory tract, it is considered a considerable health problem in adults and children when it becomes chronic and hypersensitive. However, the need for biomarkers for chronic cough in children and adults is critical. The problem with cough is also a severe symptom in hypersensitivity children. Respiratory infections are a considerable challenge for pediatricians, especially in allergic children. The term cough hypersensitivity syndrome, although introduced in adults, was questioned for children. Eosinophil cationic protein (ECP) is a promising marker for chronic cough but still needs to be validated and proved in clinical settings. In this review article, we aimed to discuss the possible role of ECP in connection to IgE for chronic cough in children. Full article

11 pages, 2000 KiB

Open AccessReview

Chronic Rhinosinusitis with Nasal Polyposis in People with Cystic Fibrosis

by Jessa E. Miller, Jennifer L. Taylor-Cousar and Daniel M. Beswick

Sinusitis 2023, 7(2), 27-37; https://doi.org/10.3390/sinusitis7020004 - 31 Oct 2023

Cited by 2

Abstract

Cystic fibrosis (CF) is an autosomal recessive disorder that results in deranged ion transport and affects multiple organ systems, including the upper and lower respiratory tracts. People with CF (PwCF) often develop chronic rhinosinusitis (CRS) with or without nasal polyposis. CRS can significantly [...] Read more.

Cystic fibrosis (CF) is an autosomal recessive disorder that results in deranged ion transport and affects multiple organ systems, including the upper and lower respiratory tracts. People with CF (PwCF) often develop chronic rhinosinusitis (CRS) with or without nasal polyposis. CRS can significantly decrease quality of life for PwCF and can lead to more frequent pulmonary exacerbations. The management of CRS in PwCF is different from that in individuals without CF. Novel therapies have emerged in the last several years that have drastically altered the progression of both pulmonary and sinonasal disease in people with CF. It is critical for providers who manage CF-related CRS to understand the unique characteristics and challenges that coincide with this disease process. This review article aims to provide readers with an overview of the pathophysiology of CF and to summarize best practice strategies for the management of CF-related CRS. Full article

(This article belongs to the Special Issue Frontiers in Chronic Rhinosinusitis with Nasal Polyposis)

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15 pages, 403 KiB

Open AccessReview

Central Compartment Atopic Disease as a Pathophysiologically Distinct Subtype of Chronic Rhinosinusitis: A Scoping Review

by Camron Davies, Franklin Wu, Emily Y. Huang, Masayoshi Takashima, Nicholas R. Rowan and Omar G. Ahmed

Sinusitis 2023, 7(2), 12-26; https://doi.org/10.3390/sinusitis7020003 - 21 Sep 2023

Cited by 1

Abstract

Central compartment atopic disease (CCAD) is a distinct phenotype within chronic rhinosinusitis with nasal polyps (CRSwNP) with a pathophysiology that bridges the gap between allergy and CRSwNP, an association that was previously ambiguous. Understanding this endotype and its link to allergic disease is [...] Read more.

Central compartment atopic disease (CCAD) is a distinct phenotype within chronic rhinosinusitis with nasal polyps (CRSwNP) with a pathophysiology that bridges the gap between allergy and CRSwNP, an association that was previously ambiguous. Understanding this endotype and its link to allergic disease is crucial for improved CCAD management. Using a systematic search and an independent dual-reviewer evaluation and data extraction process, this scoping review examines the clinical features, management options, and treatment outcomes of CCAD. Central compartment (CC) polypoid changes of the MT predominantly correlate with allergic rhinitis, increased septal inflammation, oblique MT orientation, and decreased nasal cavity opacification and Lund–Mackay scores compared to other CRSwNP subtypes. CCAD patients also exhibit higher rates of asthma, allergen sensitization, and hyposmia or anosmia. Surgical outcomes, including revision rate and SNOT-22 improvement, are favorable in CCAD as well. In conclusion, CCAD primarily affects atopic individuals and is managed using endoscopic sinus surgery combined with treating the underlying allergy. Continued research is needed to further refine understanding and develop optimal treatment strategies of this emerging CRS subtype. Full article

(This article belongs to the Special Issue Frontiers in Chronic Rhinosinusitis with Nasal Polyposis)

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6 pages, 4215 KiB

Open AccessCase Report

Bleach-Induced Chemical Sinusitis and Orbital Cellulitis Following Root Canal Treatment

by Terese Huiying Low, Jun Jie Seah, Somasundaram Subramaniam, Vijayaraj Thirunavukarasu and Chew Lip Ng

Sinusitis 2023, 7(1), 6-11; https://doi.org/10.3390/sinusitis7010002 - 31 May 2023

Abstract

The authors describe an unusual case of chemical sinusitis and orbital cellulitis secondary to a sodium hypochlorite accident in a patient who had just undergone root canal treatment. The patient presented with acute, progressive symptoms of unilateral maxillary sinusitis, facial cellulitis and orbital [...] Read more.

The authors describe an unusual case of chemical sinusitis and orbital cellulitis secondary to a sodium hypochlorite accident in a patient who had just undergone root canal treatment. The patient presented with acute, progressive symptoms of unilateral maxillary sinusitis, facial cellulitis and orbital cellulitis which began hours after root canal treatment on the ipsilateral side. He was admitted to hospital under the care of the Otorhinolaryngology team and reviewed regularly by the Ophthalmologists. He underwent Endoscopic Sinus Surgery during his hospital stay. The intraoperative findings revealed necrotic sinus mucosa and slough within the involved maxillary sinus, which were suggestive of chemical burn injury induced by the highly alkaline sodium hypochlorite solution used during root canal treatment. He was treated postoperatively with regular nasal toilet, culture-directed antibiotics and topical ocular pressure-lowering eyedrops. He displayed a slow recovery with eventually no orbital sequelae, but experienced persistent cheek numbness three months post-injury. Severe chemical sinusitis with orbital cellulitis secondary to sodium hypochlorite accident is a rare complication of root canal treatment, with potentially severe consequences. It can present with symptoms similar to complicated acute bacterial sinusitis. Otorhinolaryngologists and dental surgeons should maintain a high index of suspicion when managing a patient post-root canal treatment with symptoms of unilateral sinusitis, facial cellulitis, orbital cellulitis and even airway compromise. This would allow prompt intervention before sight or life-threatening complications set in. Full article

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