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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (15 November 2022) | Viewed by 40691

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Special Issue Editors

Dr. Eugenio De Corso

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Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Interests: rhinology; otorhinolaryngology; head and neck surgery; personalized medicine
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Jacopo Galli

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Guest Editor

Fondazione Policlinico Uiversitario A Gemelli IRCCS, Universita Cattolica del sacro Cuore, Rome, Italy
Interests: laryngology; rhinology; head and neck oncology; otology; head and neck surgery; otorhinolaryngology; personalized medicine

Special Issue Information

Dear Colleagues,

Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. PM proposes to improve efficiency and quality of care, to reduce side effects and to increase long-term control of chronic disease. In the last years, the increased knowledge about classification of diseases on the molecular level has also been the basis for personalized medicine in otorhinolaryngology. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. Physicians treating patients especially with chronic disorders might find precision medicine extremely interesting to find reports on predictors of success of medical or surgical interventions. Prediction of success of treatment is crucial to allow the patient to become an active partner in the decision-making process of medical or surgical treatment. In the last years, audiology has also been faced with the potential application of precision medicine in hearing loss. Integrating precision medicine principles into translational hearing loss research and clinical practice, hearing specialists are uniquely positioned to effectively treat the heterogeneous causes and manifestations of HL on an individualized basis.

Several factors are driving increased interest in precision medicine in otorhinolaryngology. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Rhinology, head and neck cancers, hearing loss, as well as some other otolaryngology-related conditions, represent an opportunity to use precision-guided therapies. For this reason, we proposed this Special Issue of the Journal of Personalized Medicine in order to collect papers about personalized medicine in all the fields of otorhinolaryngology. Studies may explore new aspects of personalized medicine using basic science, clinical and population-based approaches.

Dr. Eugenio De Corso
Prof. Dr. Jacopo Galli
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. Journal of Personalized Medicine 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 2600 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

target therapy
chronic rhinosinusitis
head and neck oncology
allergic rhinitis
endotypyng
rhinology
otology
laryngology
immunotherapy
biomarkers

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Precision Medicine in Otorhinolaryngology: A New Challenge to Improve Outcomes in ENT Disease in Journal of Personalized Medicine (3 articles)

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18 pages, 3642 KiB

Open AccessArticle

Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life

by Massimo Mesolella, Salvatore Allosso, Roberto D’aniello, Emanuela Pappalardo, Vincenzo Catalano, Giuseppe Quaremba, Gaetano Motta and Grazia Salerno

J. Pers. Med. 2023, 13(3), 570; https://doi.org/10.3390/jpm13030570 - 22 Mar 2023

Cited by 4 | Viewed by 1757

Abstract

Purpose: A retrospective study is presented to correlate the inter-judge consistency for the different psycho-perceptual parameters of the recently proposed Impression Noise Fluency Voicing (INFVo) perceptual rating scale for substitution voices, and the vocal function as perceived by the patient. Methods: The scale Voice-Related Quality of Life (V-RQoL) and the Self Evaluation of Communication Experiences After Laryngectomy scale (SECEL)—a self-evaluation questionnaire of communicative experience after laryngectomy surgery—were administered to 89 total laryngectomees, subdivided in four groups depending on their type of alaryngeal voice (i.e., tracheoesophageal and esophageal speakers, electro larynx users, voiceless patients), in order to evaluate the impact of the impairment of the phonatory function on the quality of life. Results: No significant differences exist among the various groups on their perception of QoL using subjective questionnaires, whereas the INFVo scale has proven to be a useful tool for the description and analysis of the psychoacoustic characteristics of the vocal signal and a reliable instrument to correctly classify the patients. It is also notable that the judgement of the patients on their own voice and those of the referees are highly significant. Conclusion: Although speech rehabilitation for the acquisition of a substitution voice offers a new way of communication for the laryngectomized patients, nonetheless, their QoL is not significantly related to the type of substitution voice. Therefore, improving the patient’s adaptation to the new phonatory condition is mandatory. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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11 pages, 15508 KiB

Open AccessArticle

Parapharyngeal Space Tumors: Our Experience

by Jacopo Galli, Rolando Rolesi, Roberto Gallus, Annalisa Seccia, Alessandro Pedicelli, Francesco Bussu and Emanuele Scarano

J. Pers. Med. 2023, 13(2), 283; https://doi.org/10.3390/jpm13020283 - 2 Feb 2023

Cited by 3 | Viewed by 3635

Abstract

Para-pharyngeal space (PPS) tumors include an heterogeneous group of neoplasms, accounting for approximatively 0.5–1.5% of all head and neck tumors. Management of these neoplasms requires a careful diagnostic workout and an appropriate surgical approach to obtain good outcomes associated with minimal aesthetic drawbacks. In this study we investigated clinical onset, histologic features, surgical treatment outcomes, peri operative complications and follow up of 98 patients treated for PPS tumors in our Centre between 2002 and 2021. Furthermore, we reviewed our preliminary experience of preoperative embolization of hyper vascular PPS tumors trough SQUID12, an ethylene vinyl alcohol copolymers (EVOH) which exhibits many advantages over other embolic agents, due to its better devascularization rate and lower risk of systemic complications. Our data support the hypothesis that transoral surgery scenario should be significantly revised, as it could represent a valid treatment for tumors located in lower and prestyloyd portion of PPS. Moreover, SQUID12, a novel embolization agent, may be a very promising choice for PPS hyper vascularized tumors, ensuring higher devascularization rate, safer procedures and lower risk of systemic dispersion compared to traditional Contour treatment. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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10 pages, 1597 KiB

Open AccessArticle

Posturographic Analysis in Patients Affected by Central and Peripheral Visual Impairment

by Gabriella Cadoni, Pasqualina Maria Picciotti, Rolando Rolesi, Marco Sulfaro, Margherita Guidobaldi, Filippo Amore, Guido Conti, Gaetano Paludetti and Simona Turco

J. Pers. Med. 2022, 12(10), 1709; https://doi.org/10.3390/jpm12101709 - 13 Oct 2022

Cited by 1 | Viewed by 1818

Abstract

Although vision loss is known to affect equilibrium maintenance, postural control in patients affected by low vision has been poorly investigated. We evaluated postural stability and the ability to use visual, proprioceptive and vestibular information in different low vision patterns. Ten adults with normal vision (NC), fourteen adults affected by central visual impairment (CLV) and eight adults affected by peripheral visual impairment (PLV) were enrolled in our study. Patients underwent visual, vestibular and postural evaluation (bedside examination, Computed Dynamic Posturograophy). Motor Control Tests were performed to analyze automatic postural adaptive responses elicited by unexpected postural disturbances. Clinical evaluations did not show abnormality in all patients. In the Sensory Organization Test, CLV and PLV patients performed more poorly in conditions 3–6 and 3–4, as compared to NC subjects. The condition 5 score was significantly lower in the CLV group with respect to the PLV patients. Composite equilibrium scores demonstrated significant differences between low-vision subjects vs. NC subjects. No differences were found for somatosensorial contribution. Visual afferences showed lower values in all visually impaired subjects, while vestibular contribution was lower in the CLV patients as compared to the NC and PLV patients. MCT latencies were significantly worse in the CLV subjects. In the low-vision patients, postural control was modified with a specific pattern of strategy adaptation. Different modulations of postural control and different adaptive responses seemed to characterize CLV patients as compared to PLV subjects. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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17 pages, 2454 KiB

Open AccessArticle

Implementation of Routine Endoscopy with Narrow Band Imaging in the Evaluation of Oral and Upper Airways Lesions in Oral Chronic Graft-Versus-Host Disease: A Preliminary Study

by Letizia Nitro, Carlotta Pipolo, Paolo Castellarin, Andrea Sardella, Antonio Mario Bulfamante, Beatrice De Marco, Gabriele Magliano, Giovanni Grillo, Giovanni Felisati and Alberto Maria Saibene

J. Pers. Med. 2022, 12(10), 1628; https://doi.org/10.3390/jpm12101628 - 1 Oct 2022

Viewed by 1803

Abstract

(1) Background: The aim of our study is to investigate the main oral lesion patterns in patients with oral graft-versus-host disease and to describe and validate the use of endoscopy enhanced with narrow-band imaging (NBI) as a personalized, reliable and user-friendly tool for the early detection of oral potentially diseases. (2) Methods: We retrospectively evaluated the medical records of 20 patients with chronic GVHD and with oral manifestations, who were referred to our “Interdisciplinary Center for Oropharyngeal Pathology (CIPO)” from January 2017 to July 2022. (3) Results: Data on GVHD, oral localization and NBI endoscopic evaluation are collected. A total of six mucositis, one mucosal erythematous change, ten lichenoid-like changes, eight erosive lesions, one leukoplakia, two erythroplakia and two case of blisters were observed. Two vascular abnormalities were seen with NBI, leading to one excisional biopsy. The patient was diagnosed with squamous cell carcinoma. (4) Conclusion: Our study is the first to highlight the relevance of the routine use of endoscopy with NBI in patients with oral chronic GVHD. We highlighted its role as a reliable, reproducible, easy-to-use and tailor-made tool in the follow-up of those patients and to allow an earlier identification of aberrant neoangiogenesis related to oral potentially malignant disorders and oral cancer. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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13 pages, 829 KiB

Open AccessArticle

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study

by Davide Rizzo, Claudia Crescio, Pierangela Tramaloni, Laura M. De Luca, Nicola Turra, Alessandra Manca, Paola Crivelli, Chiara R. Tiana, Alberto Fara, Antonio Cossu, Stefano Profili, Mariano Scaglione and Francesco Bussu

J. Pers. Med. 2022, 12(10), 1585; https://doi.org/10.3390/jpm12101585 - 26 Sep 2022

Cited by 2 | Viewed by 1770

Abstract

(1) Background: Endoscopy and morphological imaging are the mainstay of the diagnostic work up of laryngeal squamous cell carcinomas (LSCCs), which can be integrated in a multidisciplinary discussion to obtain a shared pretreatment staging. (2) Methods: A retrospective evaluation of patients, managed at a tertiary university hospital in Italy and submitted to major laryngeal surgery, has been performed. Four different stagings have been defined and compared: epTN (based on endoscopy and physical ENT examination); radTN (based on CT scan); cTN (based on multidisciplinary integration of the two above); pTN based on pathology on surgical samples. Oncological outcomes have been assessed. (3) Results: Three-year relapse free and disease specific survival were 88% and 92.5%, respectively, without significant differences between partial surgeries (n = 13) and total laryngectomies (n = 32). As for the pretreatment staging, and in particular the T classification, the cTN has been revealed as more reliable than epTN and radTN alone in predicting the final pT (Cohen kappa coefficient: 0.7 for cT, 0.44 for radT, 0.32 for epT). In the partial surgery group, we did not record any positive margin nor local recurrence, with a 100% overall and disease-specific survival. (4) Conclusions: The multidisciplinary approach is fundamental in the definition of the primary lesion in LSCC, in particular in order to safely perform surgical preservation of laryngeal function, which is associated with a higher laryngectomy-free survival than irradiation but to a lower salvageability in case of recurrence. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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9 pages, 936 KiB

Open AccessArticle

Effectiveness of Dupilumab in the Treatment of Patients with Uncontrolled Severe CRSwNP: A “Real-Life” Observational Study in Naïve and Post-Surgical Patients

by Giancarlo Ottaviano, Tommaso Saccardo, Giuseppe Roccuzzo, Riccardo Bernardi, Alessandra Di Chicco, Alfonso Luca Pendolino, Bruno Scarpa, Edoardo Mairani and Piero Nicolai

J. Pers. Med. 2022, 12(9), 1526; https://doi.org/10.3390/jpm12091526 - 17 Sep 2022

Cited by 27 | Viewed by 3886

Abstract

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) represents 25–30% of all CRS cases, and in the most severe forms it is associated with a poor quality of life and a high rate of nasal polyps’ recurrence after surgery. Dupilumab has been suggested as a treatment option for severe CRSwNP. Methods: Patients with severe CRSwNP receiving dupilumab from January 2021 were followed up at 1, 3, 6, 9 and 12 months from the first administration and were considered for this study. At baseline and at each follow-up, patients underwent nasal endoscopy and completed the Sinonasal Outcome Test (SNOT)-22, a Visual Analogue Scale (VAS) for smell/nasal obstruction, the Nasal Congestion Score and the Asthma Control Test. Peak nasal inspiratory flow (PNIF), a smell test, nasal cytology and blood eosinophilia were also evaluated. Results: Forty-seven patients were included in the study. Of these, 33 patients had a history of previous surgery (ESS) and had recurrent nasal polyps, while 14 patients were naïve to nasal surgery. Both subjective and objective parameters improved after biological treatment and were correlated with each other (p < 0.05), except for the SNOT-22 and the nasal polyp’s score. No correlations were found between nasal and blood eosinophilia. No differences were observed when comparing the post-surgical and the naïve groups. Conclusions: Dupilumab improves nasal obstruction and the sense of smell and reduces the level of local inflammation in severe CRSwNP patients in a similar way in both naïve and post-surgical patients. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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13 pages, 1979 KiB

Open AccessArticle

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

by Eugenio De Corso, Carlotta Pipolo, Elena Cantone, Giancarlo Ottaviano, Stefania Gallo, Frank Rikki Mauritz Canevari, Alberto Macchi, Giulia Monti, Carlo Cavaliere, Ignazio La Mantia, Sara Torretta, Francesco Bussu, Emanuele Scarano, Paolo Petrone, Angelo Ghidini, Daniela Lucidi, Massimiliano Garzaro, Matteo Trimarchi, Veronica Seccia, Giulio Cesare Passali, Daria Salsi, Domenico Cuda, Ernesto Pasquini, Luca Malvezzi, Stefano Settimi, Gaetano Paludetti and Jacopo Galli Show full author list Hide full author list

J. Pers. Med. 2022, 12(6), 897; https://doi.org/10.3390/jpm12060897 - 29 May 2022

Cited by 27 | Viewed by 3568

Abstract

Background: Local and systemic corticosteroids have long been the workhorse in management of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted modality of prescription. We carried out a survey in Italy to capture current trends in the use of topical and systemic corticosteroids in patients with CRSwNP. Methods: A survey was set up on Survey Monkey^®. Each author distributed the link to the survey in an ad hoc manner and a total of 437 participants filled out the survey. Results: Mometasone furoate (79.3%) was the most frequently prescribed, administered daily by 61.9% of participants; the remaining preferred to discontinue treatment for brief periods to reduce side effects or to modulate the therapy in mild cases. The majority believe that a short cycle of systemic steroids should be prescribed for re-exacerbation of symptoms and that the number of cycles in the previous year should be evaluated to define control of the disease even if international guidelines do not provide clear indications on this topic. A certain degree of divergence emerged from responses regarding how long and the maximal dose of systemic steroids which place patients at high risk for adverse events. Finally, systemic corticosteroids seem to offer only temporary benefit on recovery of smell without guaranteeing long-term control even if the patient is adherent to topical corticosteroids. Conclusions: Our results highlight the need for clear guidelines on oral steroids, which could help supporting the use of a precision medicine approach, including indications for new biological agents. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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15 pages, 1057 KiB

Open AccessArticle

Chemokine Expression-Based Endotype Clustering of Chronic Rhinosinusitis

by Ulrike Förster-Ruhrmann, Agnieszka J. Szczepek, Greta Pierchalla, Joachim W. Fluhr, Metin Artuc, Torsten Zuberbier, Claus Bachert and Heidi Olze

J. Pers. Med. 2022, 12(4), 646; https://doi.org/10.3390/jpm12040646 - 18 Apr 2022

Cited by 13 | Viewed by 3012

Abstract

Chronic rhinosinusitis (CRS) with (CRSwNP) or without nasal polyps (CRSsNP) is a persistent, heterogeneous inflammatory condition affecting the upper respiratory tract. The present study aimed to improve the characterization of CRS endotypes based on the chemokine and cytokine expression pattern in the CRS tissues. Concentrations of chemokines and cytokines were measured in tissues from nasal biopsies obtained from 66 CRS patients and 25 control subjects using multiplexing or single analyte technologies. Cluster analysis based on the concentration of type-1 (MCP-3/CCL7, MIP-1 α/CCL3), type-2 (IL-5, MCP-3/CCL7, MIP-1 α/CCL3, TARC/CCL17, PARC/CCL18, IP-10/CXCL10, ECP), and type-3 (IL-22) chemokines and cytokines identified six CRS endotypes (clusters). Cluster 1 (type-3) and 2 (type-1) were associated with a low prevalence of nasal polyps, Cluster 3 (type-1, -2, -3) and Cluster 4 (type-2, -3, medium IL-22) with medium, and Cluster 5 (type-2, -3, high Il-22) and Cluster 6 (type-2) with high prevalence of nasal polyps. Asthma was highly prevalent in Cluster-6. Our findings add to the existing knowledge of CRS endotypes and may be useful for the clinical decision-making process. The advancement of biologics therapy for upper respiratory tract disorders rationalizes the personalized diagnostic approach to warrant a successful treatment and monitoring of CRS. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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12 pages, 1290 KiB

Open AccessArticle

Improved Music Perception after Music Therapy following Cochlear Implantation in the Elderly Population

by Astrid Magele, Bianca Wirthner, Philipp Schoerg, Marlene Ploder and Georg Mathias Sprinzl

J. Pers. Med. 2022, 12(3), 443; https://doi.org/10.3390/jpm12030443 - 11 Mar 2022

Cited by 7 | Viewed by 3256

Abstract

Background: Cochlear implantation (CI) and the accompanying rehabilitation has become a routine procedure in hearing restoration. Literature is sparse on elderly CI recipients focusing on the issue of age and their inclined auditory resolution, taking their diminished cognitive function into account, which requires adaptation of rehabilitation programs to overcome habituation. Objective: This study aims to show that a few adjustments in the therapy program towards age, mental, physical and auditory condition significantly improve music perception and overall auditory benefit, hence normal communication and social interactions can be found. Methods: Subjects implanted with a CI 65 years or older were compared to age-matched normal hearing subjects. Questionnaires were administered before and after ten music therapy sessions, to evaluate the participant’s music habits, the perception of sound quality and self-awareness and hearing implant satisfaction. Results: The greatest benefit was seen in participants’ gain in self-confidence and enjoyable music perception. Not only did the amount of listening to music increase, but also the impression of sound quality changed from poor up to good/very good sound quality. Conclusions: The music therapy was well accepted and resulted in beneficial subjective as well as objective outcomes towards hearing and music impression, hence improved quality of life. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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Review

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12 pages, 975 KiB

Open AccessReview

Quality of Life after Surgical Treatment for Chronic Otitis Media: A Systematic Review of the Literature

by Daniela Lucidi, Carla Cantaffa, Riccardo Nocini, Andrea Martone, Matteo Alicandri-Ciufelli, Daniele Marchioni, Livio Presutti and Giulia Molinari

J. Pers. Med. 2022, 12(12), 1959; https://doi.org/10.3390/jpm12121959 - 27 Nov 2022

Cited by 7 | Viewed by 1938

Abstract

This systematic review aims to (a) define what instruments are available to measure quality of life (QoL) in patients undergoing tympanoplasty for chronic otitis media (COM) and what is the most commonly selected timing to do so; (b) compare outcomes from different surgical techniques; and (c) describe any reported correlation between subjective and functional results. This review was conducted following the PRISMA statement recommendations. Of the 151 articles screened, 24 were included. Most studies had a prospective design. The mean age at surgery was 44.5 years. A microscopic retroauricular approach was the most common surgical technique. Most articles included both primary and revision surgeries. The most commonly used questionnaire was the Glasgow Benefit Inventory (GBI), followed by the Chronic Ear Survey (CES), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Zurich Chronic Middle Ear Inventory (ZCMEI-21). Questionnaires were administered about 12 months after surgery in most studies. Ten studies reported possible associations between hearing results and QoL. QoL assessment after COM surgery variably relies on disease-specific and non-specific questionnaires. Patients are usually evaluated 12 months after surgery, and this appears to be a suitable timing to contrast the possible bias effect of different tympanoplasty techniques associated with different healing times. A comparison between QoL outcomes in different surgical approaches cannot be made, as several influencing factors have not been detailed in the included studies. Few studies have investigated the correlation between subjective and objective outcomes of tympanoplasty for COM so far. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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16 pages, 7254 KiB

Open AccessReview

Supraglottic Localization of IgG4-Related Disease—Rare and Challenging Equity

by Magda Barańska, Joanna Makowska, Małgorzata Wągrowska-Danilewicz and Wioletta Pietruszewska

J. Pers. Med. 2022, 12(8), 1223; https://doi.org/10.3390/jpm12081223 - 27 Jul 2022

Cited by 3 | Viewed by 2823

Abstract

Supraglottic stenosis is a rare symptom, particularly in fibroinflammatory multifocal diseases, such as IgG4-related disease (IgG4-RD). There is still an inconsistency in the diagnosis of less-common locations of IgG4-RD, which causes a delay in the diagnosis and treatment. Our paper aims to analyze different aspects of IgG4-RD presenting as supraglottic stenosis, including the possible overlap with ANCA-associated vasculitis. We compare the usefulness of the recently revised ACR/EULAR and Comprehensive criteria and discuss treatment options. The review was performed according to PRISMA guidelines using the MEDLINE Pubmed and Scopus databases. The analysis includes nine papers describing supraglottic laryngeal stenosis in 13 patients. Furthermore, we present a case of a woman with ongoing supraglottic stenosis presenting with cough, temporary dyspnea and stridor as the symptoms of localized IgG4-RD. At the time of writing, the patient remains in remission while receiving treatment with cyclophosphamide and methylprednisolone. The symptoms of supraglottic localization of IgG4-RD may be severe; however, at that point, clinicians should suspect autoimmune etiology and attempt to modulate the autoimmune response instead of performing dilatation surgery—the effects of which may not result in extended intervals between interventions. The ACR/EULAR criteria show great specificity; however, when IgG4-RD is presumed, the specific treatment should be implemented. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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17 pages, 2350 KiB

Open AccessEditor’s ChoiceReview

Management of Patients with Severe Asthma and Chronic Rhinosinusitis with Nasal Polyps: A Multidisciplinary Shared Approach

by Veronica Seccia, Maria D’Amato, Giulia Scioscia, Diego Bagnasco, Fabiano Di Marco, Gianluca Fadda, Francesco Menzella, Ernesto Pasquini, Girolamo Pelaia, Eugenio Tremante, Eugenio De Corso and Matteo Bonini

J. Pers. Med. 2022, 12(7), 1096; https://doi.org/10.3390/jpm12071096 - 1 Jul 2022

Cited by 19 | Viewed by 4397

Abstract

Chronic rhinosinusitis (CRS) is one of the most frequent comorbidities associated with asthma and it contributes to an amplified global disease burden in asthmatics. CRS prevalence is much higher in asthmatic patients compared to the general population and it is more frequently related to severe asthma, especially in presence of nasal polyps (chronic rhinosinusitis with nasal polyps, CRSwNP). Moreover, asthma exacerbation has a higher occurrence in CRSwNP. From a pathologic point of view, CRS and asthma share similar and connected mechanisms (e.g., type-2 inflammation). A multidisciplinary approach represents a crucial aspect for the optimal management of patients with concomitant asthma and CRSwNP and improvement of patient quality of life. An Italian panel of clinicians with different clinical expertise (pulmonologists, ear, nose and throat specialists, immunologists and allergy physicians) identified three different profiles of patients with coexisting asthma and nasal symptoms and discussed the specific tracks to guide a comprehensive approach to their diagnostic and therapeutic management. Currently available biological agents for the treatment of severe asthma act either on eosinophil-centered signaling network or type-2 inflammation, resulting to be effective also in CRSwNP and representing a valid option for patients with concomitant conditions. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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22 pages, 982 KiB

Open AccessEditor’s ChoiceReview

Personalized Management of Patients with Chronic Rhinosinusitis with Nasal Polyps in Clinical Practice: A Multidisciplinary Consensus Statement

by Eugenio De Corso, Maria Beatrice Bilò, Andrea Matucci, Veronica Seccia, Fulvio Braido, Matteo Gelardi, Enrico Heffler, Manuela Latorre, Luca Malvezzi, Girolamo Pelaia, Gianenrico Senna, Paolo Castelnuovo and Giorgio Walter Canonica

J. Pers. Med. 2022, 12(5), 846; https://doi.org/10.3390/jpm12050846 - 23 May 2022

Cited by 18 | Viewed by 5040

Abstract

Chronic rhinosinusitis (CRS) is a sino-nasal chronic inflammatory disease, occurring in 5–15% of the general population. CRS with nasal polyps (CRSwNP) is present in up to 30% of the CRS population. One-third of CRSwNP patients suffer from disease that is uncontrolled by current standards of care. Biologics are an emerging treatment option for patients with severe uncontrolled CRSwNP, but their positioning in the treatment algorithm is under discussion. Effective endotyping of CRSwNP patients who could benefit from biologics treatment is required, as suggested by international guidelines. Other issues affecting management include comorbidities, such as allergy, non-steroidal anti-inflammatory drug–exacerbated respiratory disease, and asthma. Therefore, the choice of treatment in CRSwNP patients depends on many factors. A multidisciplinary approach may improve CRSwNP management in patients with comorbidities, but currently there is no shared management model. We summarize the outcomes of a Delphi process involving a multidisciplinary panel of otolaryngologists, pulmonologists, and allergist-immunologists involved in the management of CRSwNP, who attempted to reach consensus on key statements relating to the diagnosis, endotyping, classification and management (including the place of biologics) of CRSwNP patients. Full article

(This article belongs to the Special Issue Personalized Medicine in Otorhinolaryngology)

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