Title:Patents and Recent Innovations in Topical Membrane Therapy of Refractory Rhinosinusitis
Volume: 9
Issue: 2
Author(s): Alan H. Shikani and Konstantinos G. Kourelis
Affiliation:
Keywords:
Antimicrobials, biofilms, corticosteroids, patents, refractory chronic rhinosinusitis, rhinotopic therapy.
Abstract: Chronic Rhinosinusitis (CRS), one of the commonest chronic inflammatory
disorders, is encountered daily in all healthcare settings. In its refractory form, CRS
seems to prevail over most up-to-date surgical interventions and systemic medical
remedies, owing to our poor understanding of its perplexing pathophysiology. Although
several systemic influences impinge on the progression of inflammation, the true interplay between offensive and
defensive factors takes place on-site, i.e. across the sinonasal epithelial coating. Therefore, current treatment strategies
shift the weight of CRS management toward topical modalities, which combine the benefits of surgical approach with the
healing effect of conventional medications. An explosive emergence of relevant patents is still in progress, emphasizing
the need for classification and comparison. Novel delivery methods of medications into the sinus cavities include modifications
of traditional rinses, state-of-the-art nebulizing devices, and the revolutionary concept of sustained drug application
utilizing carrier gels or nasal implants. As far as the introduction of new medications is concerned, recent patents propose
alterations to the physical and chemical properties of irrigating solutions, as well as the local use of antiseptics, hydragogues,
and anti-biofilm agents. This review focuses on the local pathophysiologic events of CRS and the most exciting
innovations regarding its topical management.