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Diagnosis, Therapeutic Approaches and Future Perspectives in the Treatment of Rhinitis

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 8552

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Dr. Antonino Maniaci

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Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
Interests: rhinology; OSA; otology; laryngology; machine learning
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Salvatore Cocuzza

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Department of Medical, Surgical Sciences and Advanced Technologies G.F.Ingrassia, University of Catania, 95100 Catania, Italy
Interests: CRS; allergy; rhinitis; biologics; nasal polyps; quality of life; sinusitis

Prof. Dr. Ignazio La Mantia

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Dear Colleagues,

Sinonasal disorders possess an extremely wide prevalence in the population and considerably affect the patient's quality of life. The diagnosis and treatment of nasal pathologies benefits from ever more current technological innovations, both in the medical and surgical fields. Surgical approaches could employ technologies such as cryosurgery, laser, electrocautery, molecular quantum resonance, and the recently introduced Kinetic oscillation stimulation at the expense of more aggressive traditional methods. The primary objective remains the preservation of the mucosa and the restoration of a physiological mucociliary clearance. On the other hand, the complete understanding of the pathophysiological mechanisms underlying dysventilation and chronic nasal inflammation permitted the introduction of molecular target therapies such as the recently approved monoclonal drugs.

Another relevant aspect in chronic inflammatory pathology of the nasal sinus is multifactoriality, which involves multiple environmental, immunological, and genetic factors. Although several potential etiological agents have been recognized as allergic comorbidities, specific microbes, mucociliary disorders, and altered epithelial barriers, the etiology remains unclear. Recent advances in culture-independent molecular techniques have improved understanding of the interactions between upper airway microbiota and chronic inflammation states and the usefulness of genetic screening as a useful predictor of relapse and treatment response.

The current monoclonal biological therapy, exploiting these pathways, has shown promising results on tissue remodeling, the control of the inflammatory immune response, the metabolism of arachidonic acid up to the recovery of mucociliary clearance, and the sense of smell of patients with chronic rhinosinusitis.

Our Special Issue aims to show the different facets of the most current therapies in the rhinology field, enhancing the increasingly less invasive approaches aimed at restoring the nasal sinus function and understanding through the most recent diagnostics available, such as may be the most promising treatment targets.

We are prioritizing high-quality original studies, but also welcome well-designed meta-analyses and reviews. We look forward to your contribution.

Dr. Antonino Maniaci
Prof. Dr. Salvatore Cocuzza
Prof. Dr. Ignazio La Mantia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

minimally invasive surgical treatment
turbinate surgery, smell and nasal mucociliary clearance
CRS, allergy, rhinitis
Th2 inflammation
biologics
nasal polyps
quality of life
sinusitis
dupilumab
omalizumab
mepolizumab
nasal microbiome
nasal polymorphisms
nasal genetics

Published Papers (3 papers)

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Research

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14 pages, 1404 KiB

Open AccessArticle

Management of Traumatic and Non-Traumatic Cerebrospinal Fluid Rhinorrhea—Experience from Three Southeast Asian Countries

by Farah Dayana Zahedi, Somasundaram Subramaniam, Pornthep Kasemsiri, Chenthilnathan Periasamy and Baharudin Abdullah

Int. J. Environ. Res. Public Health 2022, 19(21), 13847; https://doi.org/10.3390/ijerph192113847 - 25 Oct 2022

Cited by 1 | Viewed by 3969

Abstract

Background: Cerebrospinal fluid (CSF) rhinorrhea requires proper management to avoid disastrous consequences. The objectives of this study were to ascertain the patient characteristics, etiologies, sites of defect, skull base configurations, methods of investigation, and management outcomes of CSF rhinorrhea. Methods: A retrospective study was performed over 4 years involving three surgeons from Malaysia, Singapore, and Thailand. Hospital records were reviewed to determine the patients’ characteristics, the causes and sites of leaks, methods of investigation, skull base configurations, choices of treatment, and outcomes. Results: A total of 15 cases (7 traumatic and 8 non-traumatic) were included. Imaging was performed in all cases. The most common site of leakage was the cribriform plate (9/15 cases). The mean ± SD of the Keros heights were 4.43 ± 1.66 (right) and 4.21 ± 1.76 mm (left). Type II Keros was the most common (60%). The mean ± SD angles of the cribriform plate slope were 51.91 ± 13.43 degrees (right) and 63.54 ± 12.64 degrees (left). A class II Gera configuration was the most common (80%). All except two patients were treated with endonasal endoscopic surgical repair, with a success rate of 92.3%. A multilayered repair technique was used in all patients except one. The mean ± SD postoperative hospital stay was 9.07 ± 6.17 days. Conclusions: Non-traumatic CSF rhinorrhea outnumbered traumatic CSF rhinorrhea, with the most common site of leak at the cribriform plate. Imaging plays an important role in investigation, and Gera classification appears to be better than Keros classification for evaluating risk. Both conservative and surgical repairs are practiced with successful outcomes. Endonasal endoscopic CSF leak repair is the mainstay treatment. Full article

(This article belongs to the Special Issue Diagnosis, Therapeutic Approaches and Future Perspectives in the Treatment of Rhinitis)

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10 pages, 1662 KiB

Open AccessArticle

Endoscopic Endonasal Repair of Congenital Choanal Atresia: Predictive Factors of Surgical Stability and Healing Outcomes

by Salvatore Ferlito, Antonino Maniaci, Alberto Giulio Dragonetti, Salvatore Cocuzza, Jerome Rene Lechien, Christian Calvo-Henríquez, Juan Maza-Solano, Luca Giovanni Locatello, Sebastiano Caruso, Francesco Nocera, Andrea Achena, Niccolò Mevio, Gabriella Mantini, Giorgio Ormellese, Angelo Placentino and Ignazio La Mantia

Int. J. Environ. Res. Public Health 2022, 19(15), 9084; https://doi.org/10.3390/ijerph19159084 - 26 Jul 2022

Cited by 2 | Viewed by 1430

Abstract

Background: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). Methods: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach was performed in 38 unilateral or bilateral C.C.A. children. All the patients were clinically and radiologically assessed and followed for at least 2 years. Seven outcome measures were applied. Consequently, surgical success was correlated with all the independent variables reported. Results: 18/38 (47.36%) patients presented normal postoperative healing, 8/38 (21.05) had moderate restenosis (<50%), while 12/38 (31.57%) cases were severe (>50%), requiring a surgical revision. No statistical significance was found for average hospital stay between stenosis >50% and <50% patients (p = 0.802) and postoperative pain (p = 0.075); instead, the severe restenosis group demonstrated a higher delay of breast suction (p < 0.001). Among the independent variables predictors of surgical success, the presence of Charge syndrome and rhinopharyngeal stenosis demonstrated higher risks for surgical revision (OR: 4.00, 95% CI: 0.57–28.01, and OR: 2.75, 95% CI: 0.55–13.69, respectively). On the contrary, the hypoplastic inferior turbinate and bilateral C.C.A. showed a lower risk for severe restenosis by a higher endoscopic surgical space and creating a single larger opening (OR: 0.88, 95% CI: 0.22–3.52, and OR: 0.45, 95% CI: 0.10–2.08). Conclusion: Several independent variables could influence the surgical success after C.C.A. endoscopic repair; however, more high-quality evidence is needed to generate an effective predictive model. Full article

(This article belongs to the Special Issue Diagnosis, Therapeutic Approaches and Future Perspectives in the Treatment of Rhinitis)

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Review

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16 pages, 2216 KiB

Open AccessFeature PaperReview

Reshaping the Management of Allergic Rhinitis in Primary Care: Lessons from the COVID-19 Pandemic

by Baharudin Abdullah, Kornkiat Snidvongs, Niken Lestari Poerbonegoro and Budi Sutikno

Int. J. Environ. Res. Public Health 2022, 19(20), 13632; https://doi.org/10.3390/ijerph192013632 - 20 Oct 2022

Cited by 3 | Viewed by 2499

Abstract

The COVID-19 pandemic presented unique challenges to the delivery of healthcare for patients with allergic rhinitis (AR) following its disruption and impact on the healthcare system with profound implications. Reliance on self-care for AR symptom management was substantial during the pandemic with many patients encouraged to only seek in-person medical care when necessary. The advantage of digital technology becomes apparent when patients and healthcare providers had to change and adapt their method of interaction from the regular physical face-to-face consultation to telehealth and mobile health in the provision of care. Despite the pandemic and the ever-evolving post pandemic situation, optimal management of AR remains paramount for both patients and healthcare professionals. A reshaping of the delivery of care is essential to accomplish this goal. In this paper, we present what we have learned about AR management during the COVID-19 pandemic, the role of digital technology in revolutionizing AR healthcare, screening assessment in the identification and differentiation of common upper respiratory conditions, and a framework to facilitate the management of AR in primary care. Full article

(This article belongs to the Special Issue Diagnosis, Therapeutic Approaches and Future Perspectives in the Treatment of Rhinitis)

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