Medical Therapies for Adult Chronic Sinusitis: A Systematic Review
Kholood Assiri
Abstract
Chronic sinusitis is an inflammatory disease of the paranasal sinuses that usually manifests as chronic sinonasal symptoms.. Since the pathophysiology of chronic rhinosinusitis in children and adults varies significantly, as do the medical and surgical treatments, this review exclusively discusses adult chronic rhinosinusitis and explores the medical therapies used to treat chronic sinusitis in adult patients. A systematic review was performed involving studies of medical therapies used to treat chronic sinusitis in adult patients between 2016 and 2022. The PubMed and Google scholar databases were used to explore studies regarding our subject. The keywords included "Medical therapy, treatment, chronic, sinusitis, rhinosinusitis, and adult" and were used in various combinations. Original research reporting medical therapies used in treating chronic sinusitis in adult patients and full-text publications served as the inclusion criterion. Though 166 articles were obtained, only eight met the inclusion criteria. The studies included 2884 participants; all the studies were clinical trials. The review found Dupilumab to be well-tolerated and provided rapid, significant, and clinically meaningful improvements for patients with chronic sinusitis and nasal polyposis (CRSwNP). In addition, it produced rapid and sustained improvement in the sense of smell, alleviating a cardinal symptom of severe CRSwNP. Furthermore, Dupilumab improved upper and lower airway outcome measures and health-related quality of life in patients with severe CRSwNP and comorbid asthma. Another therapy was Omalizumab, which produced positive outcomes on all endpoints in participants who switched from placebo to Omalizumab through week 52. In addition, endoscopic sinus surgery, combined with medical therapy, it was found to be more efficacious than medical therapy alone in patients with CRSwNP.