HWN Suggests

Charting a New Course for CRS Treatment

Millions of patients with chronic rhinosinusitis (CRS) reach a crossroads. They haven’t had success with available medical treatment options and are now faced with a decision of whether to try endoscopic sinus surgery to help alleviate symptoms. While surgery can help some patients, it’s not an ideal solution for everyone. Of the four million patients who experience limited or no benefit from medical therapy for CRS, only about 10% opt for surgery. Even if a patient does choose sinus surgery, he or she will still need medical management because the underlying cause of inflammation is not eliminated.

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 Improving the Quality of Life for CRS Patients

As an otolaryngologist, I see the effects of chronic rhinosinusitis (CRS) on patients firsthand, and these go well beyond persistent nasal congestion, discharge, and facial pain and pressure. This condition affects one’s quality of life, with significant impacts on sleep, mental health, productivity at work and social and family relationships.

Articles of Interest

Chronic Rhinosinusitis

Our 12th episode focuses on a topic common in otolaryngology and primary - chronic rhinosinusitis. Join us to discuss the evaluation of a patient with chronic rhinosinusitis and some pearls for the OR!

Chronic Rhinosinusitis: Potential Role of Microbial Dysbiosis and Recommendations for Sampling Sites

Current medical and surgical treatments are often very broadly applied across the patient population. Maximal medical therapy (MMT) is recommended as initial treatment and may include nasal saline irrigations, topical and oral corticosteroids and antibiotics.

Expanding the Options for CRS Treatment

Google “chronic rhinosinusitis” and you’ll find it’s the clinical name for the condition where sinuses are swollen and inflamed for three months or longer, despite treatment.

Implications for Chronic Rhinosinusitis

CRS is an inflammatory disease of the nasal and paranasal mucosa with persistent symptoms for longer than 3 months; its ultimate end stage is inflammatory mucosal thickening and, in a subset of patients, polypoid changes.

It Takes 10 Years for Your Sinuses to Recover From Smoking

Not surprisingly, then, researchers found that smokers with CRS showed overall worse symptoms than their non-smoking counterparts. They also reported using more antibiotics and oral corticosteroids (which help reduce inflammation in the sinuses).

New medication advances treatment for chronic rhinosinusitis with nasal polyps

Dupilumab is a human-derived monoclonal antibody, a type of drug that enlists the body’s immune system to help it do its job. It specifically inhibits IL-4 and IL-13 cytokines, chemicals involved in the inflammatory allergic response that leads to symptoms. It is given by injection, under the skin, every other week. It can be administered in a doctor’s office or self-administered at home.

The management of chronic rhinosinusitis in primary care: an evidence-based guide

CRS is reported to affect 5–15% of the general population but only 2–4% of this is diagnosed by a doctor. Awareness of the relevant definitions will aid diagnosis and management of this common, but underdiagnosed, condition.

Tomomi's Story: Life Without a Sense of Smell

The smell of a newborn baby, the aroma and taste of fresh strawberries, the warning scent of gas that signals a leak. For Tomomi, whose chronic rhinosinusitis with nasal polyposis (CRSwNP) means that she has lived without a sense of smell, all of these scents – and the important moments and warnings that come with them – have been missing during periods of her life.

Resources

WikiDoc

Rhinosinusitis is the inflammation of the nasal mucosa and paranasal sinuses. The terms sinusitis and rhinosinusitis are used interchangeably, although rhinosinusitis is preferred because inflammation of the paranasal sinuses rarely ever occurs without concurrent inflammation of the nasal mucosa.