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Chronic rhinosinusitis: therapies in the literature

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Medical therapy for chronic rhinosinusitis in adults: review of the literature

Chronic rhinosinusitis is defined as inflammation of the nasal and sinus cavities that persists for more than 3 months.

Its incidence is increasing, as is the case with all airway diseases, which now affect almost a third of the population and are associated with a reduction in quality of life, productivity, and sleep quality, as well as high social costs.

Rhinosinusitis Rhinosinusitis: where nasal irrigation with volume acts <100 ml[caption] numerosi sono i presidi terapeutici suggeriti in letteratura ed una revisione dei dati pubblicati sulla reale utilità di ogni singolo farmaco per la terapia e prevenzione delle riacutizzazioni è indispensabile districarsi un tale labirinto poter consigliare più indicata al minor costo biologico sociale. la 29 studi totale 5181 pazienti ha evidenziato come:

  • in preventing flare-ups are indicated for daily and long-term use of:
  • in the exacerbation therapy find directions
    • in polyposis
      • systemic steroids (14–21 days)
      • short-term antibiotics (21 days)
    • in sinusitis without polyps
      • long-term antibiotics (3 months)
      • systemic steroids (14–21 days)

Diagnosis

The recognized diagnostic criteria for chronic rhinosinusitis are:

  • the presence of at least 2 of the following obvious symptoms for at least 3 months:
  • concomitant presence of at least one of the following signs of inflammation:
    • nasal polyps
    • edema or pus in the middle meatus
    • Positive CT scan for inflammation

Therapy present in literature

The therapeutic measures proposed in the literature for the treatment of chronic rhinosinusitis are:

  • topical steroids
  • irrigation with high volume (>100 ml) of saline solution
  • leukotriene antagonists (montelukast)
  • specific immunotherapy (SIT) in cases of proven allergy
  • systemic steroids
  • short-term antibiotics (3 weeks): doxycycline
  • long-term antibiotics (3 months): macrolides
  • immunotherapy with monoclonal antibodies (omalizumab et al.)
  • topical antibiotics or antifungals (mupirocin, amphotericin B)

Information message on the correlation between high-volume nasal irrigation and treatment for chronic sinusitis in adults.

Jama 2015;314 (9):926-939 – Clinical Review & Education

Luke Rudmik et al.

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