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Öğe Are antifungals effective in rhinosinusitis?(Springer International Publishing, 2020) Ak, Semih; Bayar Muluk, Nuray; Passali, DesiderioIt is now more popular to refer to rhinosinusitis rather than sinusitis, since inflammation virtually never occurs in the sinuses alone, without a nasal component. It is probable that expert disagreement on how to define CRS stems from the multifaceted nature of the disorder and from our imperfect knowledge about the underlying pathogenesis of sinus mucosal inflammation. It has been hypothesised that a number of different processes may drive inflammation: infection by bacteria (which may then produce a biofilm and secrete supertoxins), infection by viruses, allergic responses to fungal organisms (allergic fungal sinusitis), infection by fungi (invasive), immune malfunction targeting non-pathogenic fungal organisms found throughout the environment, humoral immunodeficiency and rhinitis of allergic and nonallergic type. This lack of clear diagnostic criteria to permit recruitment into trials, due to the disparate nature of CRS, coupled with, at best, a partial knowledge of the disorder's pathogenetic basis, results in a situation where clinicians need to rely on a slender evidence base when deciding what therapy to offer patients. In this chapter, antifungal treatment in rhinosinusitis is reviewed. © Springer Nature Switzerland AG 2021.Öğe The International Study of the Allergic Rhinitis Survey: outcomes from 4 geographical regions(Asia Pacific Assoc Allergy, Asthma & Clinical Immunology, 2018) Passali, Desiderio; Cingi, Cemal; Staffa, Paola; Passali, Francesco; Muluk, Nuray Bayar; Bellussi, Maria LuisaBackground: Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. Objective: We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. Methods: In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions-Asia, Europe, the Americas, and Africa. Results: The prevalence of AR was reported to be 15%-25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H-1-antihistamines (82.69%). Conclusion: A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.Öğe Newborn epistaxis(Springer International Publishing, 2023) Ceyhan, Aykut; Muluk, Nuray Bayar; Passali, DesiderioEpistaxis in infants under 2 years of age requires particular treatment, even though emergency doctors see patients with this symptom on a regular basis. Epistaxis is uncommon in this age range and may indicate a serious underlying etiology, such as severe systemic illness or nonaccidental trauma [1]. Thus, it is vital to examine the assessment and treatment of epistaxis in this age range [2]. © Springer Nature Switzerland AG 2023. All rights reserved.Öğe Septoplasty in children(Sage Publications Inc, 2016) Cingi, Cemal; Muluk, Nuray Bayar; Ulusoy, Seckin; Lopatin, Andrey; Sahin, Ethem; Passali, Desiderio; Manea, ClaudiuObjectives: Physicians have long had concerns about the potential harmful effects of pediatric septoplasties on the nasoseptal growth process because septal cartilage is important for the growth and development of the face. Methods: In this review article, pediatric septoplasty and its indications are discussed, together with a literature survey. In addition, overviews of development of the nasal skeleton from neonate to adult, nasal growth, and cartilaginous septum are presented. Important issues and comments on pediatric septoplasties are provided. Results: During septoplasty procedures, elevation of the mucoperichondrium unilaterally or bilaterally does not negatively affect growth of the face. Stabilization of the septum may be easier when mucosal elevation is performed unilaterally. The nasal floor mucosa should not be elevated so to avoid damage to the incisive nerves. Corrections and limited excisions may be done from the cartilaginous septum. Separation of the septal cartilage from the perpendicular plate, especially at the dorsal part, should not be performed because this area is important for the length and height of the nasal septum and nasal dorsum. Incisions or excisions should not be performed through the growing and supporting zones, especially at the sphenoethmoid dorsal zone. Conclusion: If there are severe breathing problems related to the septal deviation, septoplasty should be performed. In the majority of cases, septal surgery may be conducted in 6-year-old children. However, if necessary, septal surgery may be performed in younger children and even at birth.Öğe A survey on chronic rhinosinusitis: opinions from experts of 50 countries(Springer, 2016) Passali, Desiderio; Cingi, Cemal; Cambi, Jacopo; Passali, Francesco; Muluk, Nuray Bayar; Bellussi, Maria LuisaChronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Society of Rhinology. In 79.1 % of the 50 countries, the proportion of patients suffering from CRS was 15 %. Nasal symptoms were more intense in winter (46 % of countries), and spring and autumn (22 %). The most common symptoms were nasal obstruction (86 %), postnasal drip (82 %) and headache (52 %). The most common investigative modalities in the assessment of CRS are paranasal sinus CT, fiberoptic endoscopy, and anterior rhinoscopy. CRS patients were principally treated by otorhinolaryngologists (70 %). Medical treatments included nasal corticosteroids (90 %), nasal washes (68 %), and nasal decongestants (32 %). In 88 % of countries, more than 50 %, or "about 50 %", of all patients reported subjective symptom improvement after treatment. In most of the countries, surgery was required by 20-35 % of all CRS patients. During post-surgery follow-up, nasal washes (90 %), nasal corticosteroids (76 %), and systemic antibiotics (32 %) were prescribed. In 20-40 % of all patients, CRS was associated with nasal polyps. In such patients, the medical treatment options were nasal corticosteroids (90 %), systemic corticosteroids (50 %), nasal washes (46 %), and systemic antibiotics (34 %). Treatment of CRS patients varies in different countries. Paranasal sinus CT is the most common investigative modality in the assessment of CRS, and nasal corticosteroids are the first-line treatment, in the absence or presence of nasal polyps.
