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Recalcitrant chronic rhinosinusitis: What to do next?
Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...
Updates on current evidence for biologics in chronic rhinosinusitis
For a comparatively short piece, this article manages to pack in a lot of important information about a complex emerging area of rhinology – immunologically targeted therapy (biologics). Immunologically targeted therapy is a rapidly progressing and expanding domain which is...
Precision medicine in allergic rhinitis and chronic rhinosinusitis
Precision medicine (PM) with its ‘four Ps’ (personalised, predictive, preventive and participatory) is about appreciating differences between individuals when offering management options for health problems. Multiple groups interested in rhinology such as EPOS and ARIA supported a review of the...Staphylococcus aureus as a cause of refractory chronic rhinosinusitis
Staphylococcus aureus has long been linked to chronic rhinosinusitis, particularly recalcitrant cases. In this article, Alkis Psaltis describes how newer techniques have shown higher rates of S. aureus infection than were previously thought, and explains how the bacteria are able...Timing of surgery in chronic rhinosinusitis: does it matter?
While many patients with chronic rhinosinusitis respond to medical treatment, some do not. The next step for these patients is surgery, but how soon should this be offered? Sooner rather than later seems to be the answer, as Claire Hopkins...
COVID-19 in patients with chronic rhinosinusitis with polyps. Are they at risk?
COVID-19 entry factors are highly present in nasal epithelial cells. These factors include ACE2 and TMPRSS2. Their presence in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) was not investigated before. Authors investigated expression of ACE2 and TMPRSS2 in two...
Chronic rhinosinusitis, are we treating the same disease?
Chronic rhinosinusitis (CRS) is a heterogenic disease. The effects of heterogeneity on treatment outcome are not very clear. Authors used clinical features such as endoscopic findings scores and full blood count findings in addition to analysis of 35 molecular markers....
Biologicals for severe chronic rhinosinusitis with nasal polyps. Any use?
Recent advances and knowledge of inflammatory endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) led to introduction of biological agents such as monoclonal antibodies targeting IgE (omalizumab) and Interleukins (ILs) such as IL4R alpha (dupilumab) and IL5. The European Academy...
A more comprehensive management for eosinophilic chronic rhinosinusitis after FESS
In recent years there has been increasing recognition of eosinophilic chronic rhinosinusitis which, in particular, results in persistent symptoms and recurrence of nasal polyps, even after FESS surgery. It therefore calls for measures adjuvant to FESS to stop persistence of...
Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?
Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...Biologic therapies for chronic rhinosinusitis with nasal polyps: a new paradigm
Surgery for nasal polyposis has evolved significantly in the last 30 years, and now the medical management may be on the cusp of a revolution. Biologics using monoclonal antibodies to target specific immune pathways have introduced a paradigm shift in...
