Rhinosinusitis: clinical-based phenotyping.
Keywords:
rhinosinusitis, clinical-based phenotyping, phytomedicine, non-pharmacological remedies, local bacteriotherapy.Abstract
Rhinosinusitis (RS) is a common disease and is currently classified into two main types: acute RS (ARS) and chronic RS (CRS), which in turn includes CRS with or without nasal polyps. Different guidelines consider this classification. However, in clinical practice, other phenotypes exist. The current article would propose new clinical-based phenotyping of RS, including the following clinical phenotypes: simple catarrhal RS, Acute RS, acute bacterial RS, severe (complicated) acute RS, chronic RS, and recurrent chronic RS.
Treatment strategy should be tailored considering the clinical phenotype and could include phytomedicines, intranasal non-pharmacological remedies, and local bacteriotherapy.
In conclusion, RS requires thorough diagnostic work-up, and the therapeutic approach should be mainly based on appropriate management.
References
Fox SL. The use of sulfamylon in rhinosinusitis. Ann Otol Rhinol Laryngol 1947;56(4):946-52
Elise FC, Montero J. Aetiopathogenesis of rhinosinusal headaches. Prensa Med Argent 1946;33:1018-23.
Stammberger H. Endoscopic endonasal surgery--concepts in treatment of recurring rhinosinusitis. Part I. Anatomic and pathophysiologic considerations.Otolaryngol Head Neck Surg 1986;94(2):143-7
Gwaltney JM Jr, Phillips CD, Miller RD, Riker DK. Computed tomographic study of the common cold.N Engl J Med 1994;330(1):25-30
Bachert C, Pawankar R, Zhang L, et al. ICON: chronic rhinosinusitis.World Allergy Organ J 2014;7(1):25
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis.Otolaryngol Head Neck Surg 2015;152(2 Suppl): S1-S39.
Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol 2016;6 Suppl 1:S22-209
Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020.Rhinology 2020;58(Suppl S29):1-464
De Corso E, Lucidi D, Cantone E, et al. Clinical Evidence and Biomarkers Linking Allergy and Acute or Chronic Rhinosinusitis in Children: a Systematic Review.CurrAllergyAsthma Rep 2020;20(11):68
Hassan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe—an underestimated disease. A GA(2)LEN study. Allergy 2011;66:1216-23
Castagnoli R, Licari A, Brambilla I, Tosca M, Ciprandi G, Marseglia GL. An update on the role of chronic rhinosinusitis with nasal polyps as a co-morbidity in severe asthma.Expert Rev Respir Med 2020 (in press)
Kaur R, Chupp G. Phenotypes and endotypes of adult asthma: moving toward precision medicine. J Allergy Clin Immunol 2019;144:1-12
Guilleminault L, Ouksel H, Belleguic C, et al. Personalised medicine in asthma: from curative to preventive medicine. Eur Respir Rev 2017;26:143
Scaglione F, Petrini O. Mucoactive Agents in the Therapy of Upper Respiratory Airways Infections: Fair to Describe Them Just as Mucoactive?Clin Med Insights Ear Nose Throat 2019;12:11795506188219
Achilles N, Mösges R. Nasal saline irrigations for the symptoms of acute and chronic rhinosinusitis.Curr Allergy Asthma Rep 2013;13(2):229-35
Pereira H, Sousa DA, Cunha A, et al. Hyaluronic Acid.Adv Exp Med Biol. 2018;1059:137-153
Ciprandi G, Bellussi LM, Passali GC, Damiani V, Passali D. HMGB1 in nasal inflammatory diseases: a reappraisal 30 years after its discovery. Expert Rev Clin Immunol 2020; 16(5):457‐463
Maiolino L, La Mantia I, Grillo C, Grillo Ct, Ciprandi G. Dystrophic rhinitis: etiopathogenetic mechanisms and therapeutic strategy for functional recovery. J Biol Reg Hom Ag (in press)
Rot P, Rapiejko P, Jurkiewicz D. Intranasal steroid therapy - EPOS 2020.Otolaryngol Pol 2020;74(3):41-49
DeBoer DL, Kwon E. Acute Sinusitis.StatPearls2020 Aug 10
Shakhova EG. Comparative study of the efficacy of combined nasal, topical drug, and topical decongestants in the treatment of acute rhinosinusitis].VestnOtorinolaringol 2020;85(4):46-50
Pietruszewska W, Barańska M, Wielgat J. Place of phytotherapy in the treatment of acute infections of upper respiratory tract and upper gastrointestinal tract.Otolaryngol Pol 2018;72(4):42-50
Passali D, Loglisci M, Passali GC, Cassano P, Rodriguez HA, Bellussi LM. A prospective open-label study to assess the efficacy and safety of a herbal medicinal product (Sinupret) in patients with acute rhinosinusitis. ORL 2015;77:27-32
Rosenfeld RM. Clinical practice. Acute sinusitis in adults. N Engl J Med 2016;375:962-70
Brook I. Acute sinusitis in children. Pediatr Clin North Am 2013;60:409-24
Perić A, Gaćeša D, Barać A, Sotirović J, Perić AV. Herbal Drug EPs 7630 versus Amoxicillin in Patients with Uncomplicated AcuteBacterial Rhinosinusitis: A Randomized, Open-Label Study.Ann Otol Rhinol Laryngol 2020;129(10):969-976
Wu D, Bleier BS, Wei Y. Current Understanding of the Acute Exacerbation of Chronic Rhinosinusitis.Front Cell Infect Microbiol. 2019;9:415
Dimitri-Pinheiro S, Soares R, Barata P. The Microbiome of the Nose-Friend or Foe?Allergy Rhinol (Providence) 2020;11:2152656720911605
Ciprandi G, La Mantia I, Damiani V, Passali D. Local Bacteriotherapy – a promising preventive tool in recurrent respiratory infections. Exp Rev Clin Immunol 2020 (in press)
Kim DK, Kang SI, Kong IG, et al. Two-Track Medical Treatment Strategy According to the Clinical Scoring System for Chronic Rhinosinusitis. Allergy Asthma Immunol Res 2018;10(5):490-502
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Giorgio Ciprandi, Desiderio Passali, Luisa Maria Bellussi, Francesco Maria Passali
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
