SM14: Advances in Otolaryngology Improve Surgical Techniques, Treatment of Common Disorders

Chronic rhinosinusitis (CRS) without polyps is fairly homogenous, but differentiation has to be made in CRS with polyps, he said. His center is looking at immunotherapy in patients who have asthmatic CRS with allergy. “In this group of patients, immunotherapy would be very helpful,” he said. “In fact, we’ve had several patients who have been steroid-dependent, [but] we’ve been able to get them off oral steroids with immunotherapy.”

For patients with aspirin triad, zileuton, a 5-LO enzyme inhibitor, can be helpful, because it blocks production of cysteinyl leukotriene, which drives inflammation in these patients. Before this treatment, though, a baseline liver function test (LFT) is needed. Approximately 4% of cases will develop elevated LFT, but in about half these patients, those levels eventually return to normal, Dr. Han added.

Additionally, leukotriene antagonists may be used in treating cystic fibrosis, he said.

“Understand that there are many different types of sinusitis,” he said, “and that medical treatment varies depending on what type of sinusitis you have.”