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Management, Pathogenesis, and Treatment of Rhinosinusitis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 6300

Special Issue Editor


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Guest Editor
Department of Clinical Sciences and Community Health, Ospedale Maggiore Policlinico Pad. Monteggia, Milan, Italy
Interests: infectious otolaryngology; pediatric otolaryngology; rhinosinusitis
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Special Issue Information

Dear Colleagues,

Rhinosinusitis is a very common condition, presenting with different clinical phenotypes and molecular endotypes. Pathogenesis is not fully understood, and neither is the interplay between nasosinusal inflammation and systemic comorbidities, including lower airway disease. In recent decades, bacterial biofilm and impairments in respiratory microbioma have been considered to be among pathogenic factors. The effectiveness of conventional (medical or surgical) treatment is not completely predictable, and personalised treatment focusing on biological, anatomic, and microbiological characterization could be more effective.

For an upcoming Special Issue in the Journal of Clinical Medicine (PubMed indexed), we invite authors to contribute articles focusing on the diagnosis, treatment, and pathogenesis of rhinosinusitis in both adult and pediatric patients. Potential topics may include but are not limited to the following:

  • Biological mediators, including nitric oxide and pathogenesis;
  • Endotypes of chronic rhinosinusitis;
  • The microbiological basis of rhinosinusitis, including the role of biofilm and microbiota;
  • The allergological basis of rhinosinusitis;
  • Nasal cytology;
  • Imaging in diagnostic management;
  • Medical treatment, including target therapy;
  • Surgical treatment;
  • Chronic rhinosinusitis in patients with systemic disease;
  • Rhinosinusitis in children;
  • Odontogenic sinusitis;
  • Complicated rhinosinusitis.

Dr. Sara Torretta
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 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

  • Rhinosinusitis
  • Allergy
  • Endoscopic sinus surgery
  • Nasal polyposis
  • Children
  • Biofilm
  • Microbioma

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Published Papers (2 papers)

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Research

7 pages, 949 KiB  
Article
Relationship between the Severity of Inflammatory Changes in Chronic Sinusitis and the Level of Vitamin D before and after the FESS Procedure
by Paulina Kalińczak-Górna, Kamil Radajewski and Paweł Burduk
J. Clin. Med. 2021, 10(13), 2836; https://doi.org/10.3390/jcm10132836 - 27 Jun 2021
Cited by 5 | Viewed by 2291
Abstract
There have been a few reports confirming that vitamin D (VD3) deficiency increases inflammation in the paranasal sinuses. The work brings new information that, despite the presence of inflammation before surgery, patients with higher vitamin D levels had less inflammation, and this has [...] Read more.
There have been a few reports confirming that vitamin D (VD3) deficiency increases inflammation in the paranasal sinuses. The work brings new information that, despite the presence of inflammation before surgery, patients with higher vitamin D levels had less inflammation, and this has been proven on three levels. We show that vitamin D levels clearly correlate with the severity of the disease in chronic sinusitis. These results have been confirmed in imaging studies (Lund MacKay scale), endoscopy (Lund-Kennedy scale) and in the SNOT 20 questionnaire. 40 patients suffering from chronic sinusitis were divided into two equal groups: group 1: with less severe radiological changes (10 or less points on the Lund-Mackay scale), group 2: with a more advanced form (>10 points). The relationship between VD3 and the severity of the disease (clinical and nasal endoscopy) was assessed. The mean VD3 level in patients in group 2 before surgery was lower (23.01 ng/mL) than in group 1 (28.02 ng/mL) (p < 0.05). They presented a higher degree of advanced changes in all the above scales, i.e., before the SNOT 20 procedure, the mean was: group 1: 30.33, group 2: 31.80 (p < NS); Lund-Kennedy: group 1: 3.21, group 2: 6.30 (p < 0.05). After surgery an increase in VD3 levels was observed in both study groups: in group 1 to the value of 37.98 ng/mL (p < 0.002) and in group 2 to 27.67 ng/mL (p < 0.004). Lower VD3 levels were found in patients with a higher stage of the disease. Reduction of inflammation increases the level of VD3 and reduces subjective and objective symptoms of chronic inflammation. Full article
(This article belongs to the Special Issue Management, Pathogenesis, and Treatment of Rhinosinusitis)
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11 pages, 860 KiB  
Article
Quality of Life Outcomes in Frontal Sinus Surgery
by Christos Georgalas, Marios Detsis, Ioannis Geramas, Dimitris Terzakis and Andreas Liodakis
J. Clin. Med. 2020, 9(7), 2145; https://doi.org/10.3390/jcm9072145 - 8 Jul 2020
Cited by 7 | Viewed by 3328
Abstract
Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 [...] Read more.
Introduction: Although significant experience has been gained in the technical nuances of endoscopic sinus surgery procedures, the patient-reported outcomes of frontal endoscopic sinus surgery procedures are still poorly understood. In this study we used the validated patient outcome measure Sino Nasal Outcome Test-22 (SNOT-22) to assess the preoperative and postoperative quality of life in patients undergoing extended endoscopic frontal sinus surgery (Draf type 2 and Draf type 3 procedures). Methods: Out of a total of 680 patients undergoing endoscopic sinus and skull base surgery and 186 patients undergoing frontal sinus surgery, 99 chronic rhinosinusitis patients with (CRSwNP) or without (CRSnNP) nasal polyps undergoing Draf 2 or Draf 3 were assessed. Results: The mean preoperative SNOT-22 was 45.6 points for patients undergoing Draf 2 and 59 for patients undergoing Draf 3, while the mean radiological Lund–Mackay Score was 14.3 and 14.5, respectively. Mean SNOT 22 improvement was 22.9 points for Draf 2 and 37 points for Draf 3 respectively and remained significant in all time intervals, including at 4 years after surgery. With the exception of loss of smell/taste, all symptoms improved by a far bigger extent in Draf 3 group, despite the considerably worse starting point. Effect size (Cohen / Standard Deviations) of Draf 3 was greatest in the following symptoms: “being frustrated/restless/irritable” (1.63), “nasal blockage” (1.43), “reduced concentration” (1.35), “fatigue” (1.29) “runny nose” (1.26) and “need to blow nose” (1.17). Frontal sinus (neo) ostium was patent (fully or partly) at last follow up in 98% of Draf 2 patients and in 88% of patients following Draf 3. Patients with non-patent frontal (neo-) ostium however had a mean postoperative SNOT 22 score of 43 compared to 20 of those with patent frontal sinus (neo-) ostium, although the difference was not statistically significant. Conclusion: Patients undergoing Draf 3 have a greater burden of disease, including both nasal and emotional/general symptoms compared to Draf 2 patients; surgery results in improvement in both groups, although Draf 3 patients have the greatest benefit, especially in emotional / general symptons. In this way both groups achieve similar postoperative quality of life, despite the different starting points. Full article
(This article belongs to the Special Issue Management, Pathogenesis, and Treatment of Rhinosinusitis)
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