Know More About Chronic Rhinosinusitis

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Recently In our previous issue, we published an article entitled "Treating acute and chronic rhinosinusitis in children using an osmotic, nasal surface cleaning, the non-medicated polymeric film" by one of the eminent authors "Dr Rémi Shrivastava" Vitrobio Research Institute, ZAC de Lavaur, 63500 Issoire, France

This article is about ’’ Treating acute and chronic rhinosinusitis in children using an osmotic, nasal surface cleaning, the non-medicated polymeric film’’ One of the most prevalent diseases in children is acute and chronic rhinosinusitis, which has a significant impact on both children's and parents' quality of life. The physiopathology is complex and includes sinus drainage obstruction brought on by bacterial biofilm on sinus apertures, nasal mucosa irritation, and cellular damage. There are currently no multi-target treatments available, and no method has been found to unblock and drain obstructed sinuses. For the treatment of paediatric rhinosinusitis, we assessed the clinical efficacy of a new generation of multi-target, non-irritant, osmotic, safe, polymeric glycerol film.

Both the test product and saline nasal washes decreased rhinosinusitis symptoms, however, the test group saw this reduction far more quickly and significantly more effective than the comparative group. In comparison to 10 to 15 days for saline solution, about 50% of symptomatic alleviation was experienced with the test product within 3 days, and all patients in the test product group had recovered by day 15. None of the patients in the test product group needed rescue antibiotics therapy, as opposed to 40% of the kids in the comparative group. No side effects were noticed, making both products safe and non-irritating.

Inflammatory disorders of the paranasal sinuses and lining of the nasal mucosa (NM), rhinosinusitis (RSS) and chronic rhinosinusitis (CRSS), collectively referred to as rhinosinusitis (RS), affect more than 14% of adults and children. Although it occasionally has bacterial, fungal, or allergic causes, the illness typically begins as a viral infection after a cold caused by influenza, parainfluenza, rhinoviruses, or coronaviruses. Millions of free viral particles are released on the NM surface as a result of the initial intracellular virus development, which kills cells. These recently formed viral particles are currently attacking young, healthy cells and causing extensive NM damage. In this extremely favourable environment, opportunistic microorganisms such as Streptococcus pneumonia, Hemophilus influenza, Moraxella catarrhalis, and Beta-Hemolytic Streptococcus pyogenes begin to proliferate. 

In order to compare the effectiveness and safety of Nesospray-Kid (TP) to 0.9% NaCl saline solution (CP), a comparator product, for the treatment of acute or chronic rhinosinusitis in children, the study was designed as a comparative, randomised, double-blind, parallel-group, observational clinical trial. 20 kids in the TP group and 10 kids in the CP group received 3 to 4 sprays on their nasal surfaces every 30 minutes for the first 2 hours of treatment, and then 3 to 4 times daily for the next 15 days. Since saline solution (0.9%) shares many characteristics with the TP, it was chosen as a comparison product. 

Children younger than 3 or older than 16 who have a history of allergies to any of the ingredients in the investigational product and who are unwilling to participate in the study, as well as patients with abnormal nasal passages, polyps, recent nasal surgery, bronchopneumonia, chronic allergies, clinical evidence of immunosuppression, and RS with a known fungus- or allergy-related origin. Patients who had received any additional treatment for rhinosinusitis within the two weeks prior to screening, including antibacterial/antiviral medicine, antihistamines, and steroids. 

Antimycotics, anti-IgE, anti-IL5, novel antihistamines, complementary medicine, immunosuppressant drugs, leukotriene inhibitors, phytotherapy, probiotics, and proton pump inhibitors are some of the newly available choices. Although there are many treatments available, one may ask why none of them is effective and why RSS and CRSS still have no known cure. Theoretically, maintaining NM cleanliness, opening and draining the sinuses, and reducing inflammation and pain should be enough to improve the natural defence.  Saline solution, administered as a nasal wash, is still regarded as one of the best and safest therapies to acquire some symptomatic relief in the absence of any treatment since it is secure and has a somewhat favourable benefit/risk ratio.

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