Critical review of diagnosis in rhinology and its therapeutical implications.
Fiche publication
Date publication
octobre 2023
Journal
European annals of otorhinolaryngology, head and neck diseases
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JANKOWSKI Roger, Pr GALLET Patrice
Tous les auteurs :
Jankowski R, Favier V, Saroul N, Lecanu JB, Nguyen DT, de Gabory L, Verillaud B, Rumeau C, Gallet P, Béquignon E, Vandersteen C, Patron V
Lien Pubmed
Résumé
Diagnosis in rhinology is currently based on the concept of inflammation (chronic rhinosinusitis [CRS]) or the clinical concept of chronic nasal dysfunction (CND). The complementarity between these two approaches can be discussed by a critical review of the literature structured by the analysis of the fundamental and diagnostic bases and the therapeutic implications linked to each. The concept of CRS is based on the anatomical continuity of the nasal and sinus respiratory mucosa and molecular biology data, seeking to analyze the mechanisms of chronic inflammation and to identify proteins and biomarkers involved in the different supposed endotypes of chronic inflammation of this mucosa. The concept of CND seeks to analyze medical, instrumental or surgical diagnostic and therapeutic strategies, taking account of both inflammatory and non-inflammatory causes impacting the anatomy or physiology of each of the three noses (olfactory, respiratory and sinus) that make up the mid-face sinonasal organ of evolution-development (Evo-Devo) theory. Thus, the concept of CRS offers an endotypic approach, based on biological characterization of mucosal inflammation, while the concept of CND offers a compartmentalized phenotypic and pathophysiological approach to sinonasal diseases. The joint contribution of these two concepts in characterizing nasal functional pathology could in future improve the medical service provided to patients.
Mots clés
Chronic nasal dysfunction, Chronic rhinosinusitis, DyNaChron, Nasal polyposis, Rhinitis, SNOT-22, Sinusitis
Référence
Eur Ann Otorhinolaryngol Head Neck Dis. 2023 10 12;: