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Vol. 1 No. 1 (2024)

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August 22, 2025
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December 26, 2024

Copyright (c) 2024 Musleh Hussain Mubarki, Radeif Essa Shamakhi, Saud Sahal Matar AlOtaibi, Adnan Abdulkhaliq Alraml, Osama Abdullah Almohammed saleh, Abdullah Mohammed Almarzooq, Fahad Meshref mzal alanazi, Rahaf ali salem Alshehri, Sara zafer raja alajmi, Faisal Saad Hamoud Alotaibi, Abduallah Mohammed Almawash

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Chronic Sinusitis: A Comprehensive Review of Etiology, Diagnosis, and Modern Management

https://doi.org/10.64483/20251132
Musleh Hussain Mubarki
Kingdom of Saudi Arabia, ENT consultant, Saudi Arabia
Radeif Essa Shamakhi
Kingdom of Saudi Arabia, ENT consultant, Saudi Arabia
Saud Sahal Matar AlOtaibi
Kingdom of Saudi Arabia, Al-Hamra Health Center, Riyadh, Saudi Arabia
Adnan Abdulkhaliq Alraml
Kingdom of Saudi Arabia, General practitioner, Oyun City General Hospital, Alahsa, Saudi Arabia
Osama Abdullah Almohammed saleh
Kingdom of Saudi Arabia, General practitioner, Oyun City General Hospital, Alahsa, Saudi Arabia
Abdullah Mohammed Almarzooq
Kingdom of Saudi Arabia, General practitioner, Alomran General Hospital, Alahsa, Saudi Arabia
Fahad Meshref mzal alanazi
Kingdom of Saudi Arabia, Saudi Red Crescent, Saudi Arabia
Rahaf ali salem Alshehri
Kingdom of Saudi Arabia, Ministry of Health/Hittin Health Center, Saudi Arabia
Sara zafer raja alajmi
Kingdom of Saudi Arabia, Hayathem primary Health care center, Saudi Arabia
Faisal Saad Hamoud Alotaibi
Kingdom of Saudi Arabia, Primary Health Care Centers in Artawia, Saudi Arabia
Abduallah Mohammed Almawash
Kingdom of Saudi Arabia, king salman hospital in Riyadh, Saudi Arabia

Corresponding Author(s) : Musleh Hussain Mubarki

mhmm.1412@hotmail.com

Saudi Journal of Medicine and Public Health, Vol. 1 No. 1 (2024)

Abstract

Chronic rhinosinusitis (CRS) is a common pericranial inflammatory disease of the paranasal sinuses lasting greater than 12 weeks, which affects millions of people around the world. This review describes the multifactorial etiology of CRS, advances in CRS diagnostics, and new treatment options. The causes of CRS include anatomical obstruction, infections (microbial), allergies, and an unintended, inappropriate, and exaggerated immune response. In recent literature, the importance of biofilms, genetic background, and imbalance of the microbiome has also been examined. Therapy is composed of medical therapies (e.g., intranasal corticosteroids, antibiotics, and biologics) and surgery, including the increasingly popular functional endoscopic sinus surgery (FESS) and other types of surgical airway reconstruction. New ideas and therapies have emerged, including therapies targeting the ecosystem of the microbiome (including next-generation sequencing) and biologics, including dupilumab. The purpose of this review is to highlight diagnostic criteria, treatment options, and new therapies. By presenting current problems and new directions for research, we hope to assist clinicians and researchers to give their patients with CRS the best chance for improved outcomes.

Keywords

Chronic rhinosinusitis, sinusitis, biologics, microbiome, diagnosis.
Mubarki, M. H., Shamakhi, R. E., AlOtaibi, S. S. M., Alraml, A. A., saleh, O. A. A., Almarzooq, A. M., … Almawash, A. M. (2024). Chronic Sinusitis: A Comprehensive Review of Etiology, Diagnosis, and Modern Management. Saudi Journal of Medicine and Public Health, 1(1), 165–178. https://doi.org/10.64483/20251132
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References
  1. Bachert, C., Zhang, N., Hellings, P. W., & Bousquet, J. (2018). Endotype-driven care pathways in patients with chronic rhinosinusitis. Journal of Allergy and Clinical Immunology, 141(5), 1543-1551. https://doi.org/10.1016/j.jaci.2018.03.004
  2. Bachert, C., Bhattacharyya, N., Desrosiers, M., & Khan, A. H. (2021). Burden of disease in chronic rhinosinusitis with nasal polyps. Journal of asthma and allergy, 127-134. https://doi.org/10.2147/JAA.S290424
  3. Biel, M. A. (2014). Antimicrobial photodynamic therapy for treatment of biofilm-based infections. Biofilm-based Healthcare-associated Infections: Volume II, 119-136. https://doi.org/10.1007/978-3-319-09782-4_8
  4. Cavaliere, C., Masieri, S., Begvarfaj, E., Loperfido, A., Baroncelli, S., Cascone, F., & Ciofalo, A. (2024). Long-term perspectives on chronic rhinosinusitis with nasal polyps: evaluating recurrence rates after functional endoscopic sinus surgery in the biologics era—A 5-year follow-up study. Journal of Personalized Medicine, 14(3), 297. https://doi.org/10.3390/jpm14030297
  5. Cervin, A., & Wallwork, B. (2014). Efficacy and safety of long-term antibiotics (macrolides) for the treatment of chronic rhinosinusitis. Current allergy and asthma reports, 14(3), 416. https://doi.org/10.1007/s11882-013-0416-2
  6. Cho, H. C., Kim, Y., Cho, Y. I., Park, J., & Choi, K. S. (2024). Evaluation of bovine coronavirus in Korean native calves challenged through different inoculation routes. Veterinary Research, 55(1), 74. https://doi.org/10.1186/s13567-024-01331-9
  7. Cope, E. K., Goldberg, A. N., & Pletcher, S. D. (2023). Microbiome-targeted therapies in CRS. Otolaryngology Clinics of North America, 56(1), 89-102.
  8. Deutsch, P. G., Whittaker, J., & Prasad, S. (2019). Invasive and non-invasive fungal rhinosinusitis—a review and update of the evidence. Medicina, 55(7), 319. https://doi.org/10.3390/medicina55070319
  9. Dhar, S., Kothari, D. S., Tomescu, A. L., D’Anza, B., Rodriguez, K., Sheyn, A., & Rangarajan, S. V. (2024). Antimicrobial prescription patterns for acute sinusitis 2015–2022: a comparison to published guidelines. American Journal of Rhinology & Allergy, 38(6), 421-427. https://doi.org/10.1177/19458924241280379
  10. Fischer, J. L., & Lee, J. T. (2024). Update on the Role of the Microbiome in Chronic Rhinosinusitis. Current Treatment Options in Allergy, 11(2), 17-33. https://doi.org/10.1007/s40521-024-00361-0
  11. Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., ... & Witterick, I. (2020). European position paper on rhinosinusitis and nasal polyps 2020. Rhinology, 58(Suppl S29), I-+.
  12. Fokkens, W. J., Viskens, A. S., Backer, V., Conti, D., De Corso, E., Gevaert, P., ... & Hellings, P. W. (2023). EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023. Rhinology, 61(3), 194-202. https://doi.org/10.4193/Rhin22.489
  13. Hamilos, D. L. (2016). Chronic rhinosinusitis in patients with cystic fibrosis. The Journal of Allergy and Clinical Immunology: In Practice, 4(4), 605-612. https://doi.org/10.1016/j.jaip.2016.04.013
  14. Hopkins, C. (2019). Chronic rhinosinusitis with nasal polyps. New England Journal of Medicine, 381(1), 55-63. DOI: 10.1056/NEJMcp1800215
  15. Huang, Y., Qin, F., Li, S., Yin, J., Hu, L., Zheng, S., ... & Hu, W. (2022). The mechanisms of biofilm antibiotic resistance in chronic rhinosinusitis: A review. Medicine, 101(49), e32168. DOI: 10.1097/MD.0000000000032168
  16. Koskinen, A., Myller, J., Mattila, P., Penttilä, M., Silvola, J., Alastalo, I., ... & Toppila-Salmi, S. (2016). Long-term follow-up after ESS and balloon sinuplasty: comparison of symptom reduction and patient satisfaction. Acta oto-laryngologica, 136(5), 532-536. https://doi.org/10.3109/00016489.2015.1129553
  17. Kumar, N., Brar, T., Kita, H., Marks, L. A., Miglani, A., Marino, M. J., & Lal, D. (2023). Viruses in chronic rhinosinusitis: a systematic review. Frontiers in Allergy, 4, 1237068. https://doi.org/10.3389/falgy.2023.1237068
  18. Leland, E. M., Zhang, Z., Kelly, K. M., & Ramanathan Jr, M. (2021). Role of environmental air pollution in chronic rhinosinusitis. Current allergy and asthma reports, 21(8), 42. https://doi.org/10.1007/s11882-021-01019-6
  19. Lund, V. J., Mackay, I. S., Hopkins, C., Browne, J. P., Slack, R., Lund, V., ... & Kennedy, D. W. (2018). Radiological staging of rhinosinusitis. Landmark Papers in Otolaryngology, 126.
  20. Macias-Valle, L., & Psaltis, A. J. (2021). A scholarly review of the safety and efficacy of intranasal corticosteroids preparations in the treatment of chronic rhinosinusitis. Ear, Nose & Throat Journal, 100(5), 295-301. https://doi.org/10.1177/0145561320967727
  21. Meng, Y., Zhang, L., Piao, Y., Lou, H., Wang, K., & Wang, C. (2019). The use of magnetic resonance imaging in differential diagnosis of allergic fungal sinusitis and eosinophilic mucin rhinosinusitis. Journal of thoracic disease, 11(8), 3569. doi: 10.21037/jtd.2019.07.26
  22. Ni Mhurchu, E., Ospina, J., Janjua, A. S., Shewchuk, J. R., & Vertinsky, A. T. (2017). Fungal rhinosinusitis: a radiological review with intraoperative correlation. Canadian Association of Radiologists Journal, 68(2), 178-186. https://doi.org/10.1016/j.carj.2016.12.009
  23. Niekrash, C. E. (2023). chronic sinusitis, odontogenic sinusitis, and fungal sinusitis. Pathophysiology. Dental Science for the Medical Professional: An Evidence-Based Approach, 131. https://doi.org/10.1007/978-3-031-38567-4-13
  24. Norwood, T. G., Grayson, J. W., & Woodworth, B. A. (2023). Advances in sinus surgery for nasal polyps. American Journal of Rhinology & Allergy, 37(2), 162-167. https://doi.org/10.1177/19458924221147783
  25. Pramanik, S., Mohanto, S., Manne, R., Rajendran, R. R., Deepak, A., Edapully, S. J., ... & Katari, O. (2021). Nanoparticle-based drug delivery system: the magic bullet for the treatment of chronic pulmonary diseases. Molecular Pharmaceutics, 18(10), 3671-3718. https://doi.org/10.1021/acs.molpharmaceut.1c00491
  26. Poetker, D. M. (2015). Oral corticosteroids in the management of chronic rhinosinusitis with and without nasal polyps: Risks and benefits. American journal of rhinology & allergy, 29(5), 339-342. https://doi.org/10.2500/ajra.2015.29.4223
  27. Rudmik, L. (2015). Chronic rhinosinusitis: an under-researched epidemic. Journal of Otolaryngology-Head & Neck Surgery, 44(1), 11. https://doi.org/10.1186/s40463-015-0064-8
  28. Shaker, M. S. (2023). Chronic sinusitis in 2023: Promises of medical research realized and those yet to come. Annals of Allergy, Asthma & Immunology, 131(3), 285-286. DOI: 10.1016/j.anai.2023.06.005
  29. Stevens, W. W., Peters, A. T., Tan, B. K., Klingler, A. I., Poposki, J. A., Hulse, K. E., ... & Kato, A. (2019). Associations between inflammatory endotypes and clinical presentations in chronic rhinosinusitis. The Journal of Allergy and Clinical Immunology: In Practice, 7(8), 2812-2820. https://doi.org/10.1016/j.jaip.2019.05.009
  30. Vanderhaegen, T., Gengler, I., Dendooven, A., Chenivesse, C., Lefèvre, G., & Mortuaire, G. (2022). Eosinophils in the field of nasal polyposis: towards a better understanding of biologic therapies. Clinical reviews in allergy & immunology, 62(1), 90-102. https://doi.org/10.1007/s12016-021-08844-7
  31. Xie, X., Xuan, L., Zhao, Y., Wang, X., & Zhang, L. (2023). Diverse endotypes of chronic rhinosinusitis and clinical implications. Clinical reviews in allergy & immunology, 65(3), 420-432. https://doi.org/10.1007/s12016-023-08976-y
  32. Zajda, J., Schmidt, N. J., Zheng, Z., Wang, X., & Meyerhoff, M. E. (2018). Performance of Amperometric Platinized‐Nafion Based Gas Phase Sensor for Determining Nitric Oxide (NO) Levels in Exhaled Human Nasal Breath. Electroanalysis, 30(8), 1610-1615. https://doi.org/10.1002/elan.201800140
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