Topical Therapies and Surgical Techniques in Chronic Rhinosinusitis
Summary
Chronic rhinosinusitis (CRS) represents a persistent inflammation of the nasal and paranasal mucosa that significantly impairs patient quality of life. Management typically begins with topical medical therapies aimed at reducing mucosal oedema, improving clearance of secretions and moderating local inflammation. Topical corticosteroids delivered via sprays, nebulisers and high-volume saline irrigations are central to conservative treatment. For cases refractory to medical management, surgical intervention with functional endoscopic sinus surgery (FESS) restores sinonasal drainage pathways, widens ostial openings and enhances topical agent delivery. Surgical refinements have evolved to include minimally invasive approaches, frontal recess techniques and targeted turbinate modifications. Post-operative care increasingly relies on tailored topical regimens to maintain patency and prevent recurrence, emphasising the interdependence of surgical and medical modalities. Advances in computational modelling have guided optimal head positioning and device selection to maximise mucosal contact. Collectively, these strategies underpin a holistic approach that integrates individual anatomical considerations, surgical precision and advanced topical delivery to improve long-term outcomes and reduce disease recurrence on a global scale.
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Topical Therapies and Surgical Techniques in Chronic Rhinosinusitis publication trend
The graph below shows the total number of articles in topical therapies and surgical techniques in chronic rhinosinusitis across all publications each year (not limited to Nature Index journals).
Technical terms
Chronic rhinosinusitis: A long-lasting inflammation of the nasal and paranasal sinus mucosa characterised by nasal blockage, discharge and facial pressure.
Functional endoscopic sinus surgery (FESS): A minimally invasive surgical procedure that restores sinus ventilation and drainage via endoscopic enlargement of ostia.
Nebulisation: The process of converting liquid medication into fine aerosol droplets for intranasal delivery.
Nasal irrigation: Flushing the nasal cavity with saline or medicated solution to clear mucus and improve topical agent contact with sino-nasal mucosa.
Computational fluid dynamics (CFD): A simulation technique that models the flow and distribution of fluids within anatomically accurate sinus geometries.
High-volume steroid nasal rinse (HSNR): An irrigation modality that uses large volumes of saline mixed with corticosteroid to enhance delivery to paranasal compartments.
References
- Evaluating nebulisation and nasal irrigation efficiency in post-operative chronic rhinosinusitis patients through computational fluid dynamics simulation. Computer Methods and Programs in Biomedicine (2025).
- The Role of Corticosteroid Nasal Irrigations in the Management of Chronic Rhinosinusitis: A State-of-the-Art Systematic Review. Journal of Clinical Medicine (2023).
- Optimizing Corticosteroid Sinonasal Irrigation Outcomes Through 3D Printing: A Randomized Pilot Clinical Trial. OTO Open (2024).
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