Management and Treatment of Rhinosinusitis

Rhinosinusitis encompasses both acute and chronic inflammation of the nasal mucosa and paranasal sinuses, affecting a substantial proportion of the population and impairing quality of life through congestion, facial pain and reduced olfaction. Management is tailored according to duration and severity. Acute rhinosinusitis often resolves with supportive care, including saline irrigation, topical intranasal corticosteroids and selective use of antibiotics for suspected bacterial superinfection. Chronic rhinosinusitis represents a multifactorial condition characterised by persistent mucosal inflammation, microbial colonisation and immune dysregulation. First-line therapy comprises long-term topical corticosteroids, regular nasal irrigation and targeted antibiotics for exacerbations. In recalcitrant cases or where anatomical obstruction contributes to disease persistence, functional endoscopic sinus surgery is employed to restore ventilation and promote drainage. Recent advances focus on personalised strategies, incorporating pro-resolving lipid mediators, targeted biologic agents for type-2 inflammation, and emerging non-pharmacological approaches such as photodynamic therapy. Enhanced clinical decision support tools are improving antibiotic stewardship and facilitating precision in treatment pathways to optimise patient outcomes and limit antimicrobial resistance.

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Management and Treatment of Rhinosinusitis publication trend

The graph below shows the total number of articles in management and treatment of rhinosinusitis across all publications each year (not limited to Nature Index journals).

Technical terms

Rhinosinusitis: Inflammation of the nasal cavity and paranasal sinuses, classified by duration as acute or chronic.

Acute rhinosinusitis (ARS): Sinonasal inflammation lasting less than 12 weeks, typically following a viral infection.

Chronic rhinosinusitis (CRS): Persistent sinonasal inflammation of 12 weeks or more, often associated with mucosal oedema and polyps.

Intranasal corticosteroids (INCS): Topical steroid sprays applied to the nasal mucosa to reduce local inflammation.

Functional endoscopic sinus surgery (FESS): Minimally invasive surgical technique to restore sinus ventilation and drainage by removing obstructions.

Mucociliary clearance: Coordinated movement of mucus by cilia lining the respiratory epithelium to remove debris and pathogens.

Maresins: Specialized pro-resolving lipid mediators derived from omega-3 fatty acids that actively promote resolution of inflammation.

References

1. Long-term benefits of EPs® 7630 in patients with acute sinusitis: a real-world cohort study. Frontiers in Pharmacology (2024).
2. Orally administered Chinese herbal therapy to assist post-surgical recovery for chronic rhinosinusitis—A systematic review and meta-analysis. PLOS ONE (2023).
3. Dysregulated Maresin Concentrations in Plasma and Nasal Secretions From Patients With Chronic Rhinosinusitis. Frontiers in Immunology (2021).
4. Photodynamic Therapy as a New Treatment for Chronic Rhinosinusitis - A Systematic Review. Turkish Archives of Otorhinolaryngology (2020).
5. Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis. BMC Medical Informatics and Decision Making (2021).