Bronchial asthma is frequently accompanied by chronic rhinitis. It has been observed that effective treatment of rhinitis may reduce asthma symptoms. The aim of the study was the evaluation of the control of bronchial asthma symptoms in patients with chronic rhinitis after argon plasma coagulation turbinectomy (APCt). The effect of APCt was assessed in 47 adults with drug-resistant chronic rhinitis and bronchial asthma 3-month post-procedure. Changes of asthma symptoms were scored using Asthma Control Test (ACT). Subjective improvement of nasal congestion 3 months after APCt was observed in 87 % and of rhinorrhoea in 75 % patients. Rhinomanometry showed 219 ± 19 cm³/s increase of flow and 0.75 ± 0.06 Pa/cm³/s reduction of resistance. The prevalence of patients with insufficient bronchial asthma control decreased from 79 to 4 %. The decrease was associated with diminished frequency of eosinophils >20 % in nasal cytology from 83 % pre-procedure to 28 % in the follow-up. The percentage of eosinophils >20 % in cytology before APCt increased the chance for asthma control improvement by 22.8 times. Reduction in symptoms of drug-resistant rhinitis after APCt is followed by significant improvement of asthma control. The most beneficial therapeutic effects of APCt are noted in patients with a high rate of eosinophils in nasal cytology.

Interior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Authors analyzed long-term results of argon plasma coagulation (APC) for inferior turbinates reduction in patients with chronic nasal obstruction. Rhinomanometric parameters, clearance of saccharine test results and cytological examination were statistically analyzed in 70 patients after 3 month and in 47 after 12 month after surgery. Five patients received a second operation. Only patients with first degree in T/S (turbinate/septum) nasal septum deviation were enrolled in both groups. Every patients were treated ineffectively with nasal drops. All patients received topical anesthesia. The procedure of APC were easy to perform end we did not experience postoperative bleeding. Rhinomanometric measurement demonstrated a significant nasal flow at 3 and 12 month after APC. Before 3 and 12 month after surgery the values for resistance shoved significant difference. There were no changes in saccharine transit - time during the follow-up period. At 3 postoperative month, the nasal stuffiness had improved 62 (88%) patients. At 12 month after surgery, the nasal stuffines had improved 34 (73%) patients. APC was shown to effectively reduce the symptom of nasal obstruction without any complications. Argon Plasma Coagulation should be an alternative method in treating the patients with hyperplastic inferior turbinate.

Introduction: Severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are frequently comorbid diseases caused by type 2 inflammation. The complete etiology of these forms still remains unexplained, which makes causal and fully effective therapeutic management impossible. New therapeutic options using the knowledge of Th2 inflammatory endotype are based on anti-IL5 (mepolizumab, reslizumab), anti-IL5R (benralizumab), anti-IgE (omalizumab), and anti-IL4/IL13 (dupilumab) monoclonal antibodies. Recently, biological therapy has provided a new personalized therapeutic option for patients with CRSw NP. Aim: The aim of the study was to evaluate the efficacy of mepolizumab, benralizumab, omalizumab, and dupilumab in the reduction of rhinological symptoms in severe asthmatic patients with chronic rhinosinusitis with nasal polyps. Materials and methods: In 32 (9 male, 18%) patients with CRSwNP and severe bronchial asthma treated with biologics – mepolizumab (19, 59%), omalizumab (5, 15%), benralizumab (6, 19%), and dupilumab (2, 6%) for 6 months, a subjective evaluation of rhinologic symptoms was conducted (TNSS, SNOT, smell evaluation). Results: In all analyzed groups, 6-month treatment with mepolizumab, omalizumab, and benralizumab resulted in significant improvement in rhinitis symptoms assessed by TNSS and SNOT scales as well as in the sense of smell. Due to the small group of patients treated with dupilumab, statistical analysis in this group was not performed. Conclusions: Our real-life observation confirmed that biological therapy based on phenotyping enables achieving optimal therapeutic effects for patients with CRSwNP and severe bronchial asthma. Biological therapy should be conducted through a collaborative and multidisciplinary approach.

According to actual recommendations, the use of paraformaldehyde as a dental material should be significantly limited; however, it is still used in certain cases. Its use can cause delayed anaphylaxis, which can be life-threatening. We analyzed 157 patients admitted to an allergological clinic between 2017 and 2022 because of a hypersensitivity reaction after dental treatment. Paraformaldehyde was used in 24 of them. Positive specific IgE levels against paraformaldehyde were found in 12 patients, which constituted 50% of the whole group of patients who were treated with paraformaldehyde. Twelve patients had negative results of specific IgE against paraformaldehyde estimation (the PF group). Between the study and control groups, the anaphylactic reaction after paraformaldehyde application was analyzed from many aspects; the level of certainty of anaphylaxis according to Brighton criteria was significantly higher in the PF-positive group than in controls. None of the patients treated with paraformaldehyde as a dental material was informed by a dentist about this risk and symptoms of anaphylaxis. Patients who received paraformaldehyde during dental treatment should be informed of the possibility, symptoms, and treatment of an anaphylactic reaction, which might occur even 24 h after treatment.

Introduction: A particularly aggressive course of chronic sinusitis with nasal polyps is seen in patients with bronchial asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs). These patients often report exacerbation associated with consumption of foods reach in salicylates. Therefore, the authors analyzed the effect of a low-salicylate diet (LSD) on the course of chronic sinusitis with polyps in patients with NSAID-exacerbated respiratory disease (N-ERD) to answer the question: which patients would obtain the best therapeutic benefit? Methods: Adult patients with N-ERD were selected for dietary intervention with LSD. Patients were seen on two occasions: at an initial visit and a follow-up after 12 weeks of diet. At both visits, an evaluation was performed with total nasal symptom score (TNSS) and modified Lund-Kennedy (L-K) endoscopy score. Results: Forty patients (21 female, 52.5%, median and IQR of age 52; 43.5–61) used LSD for 12 weeks. Initial analysis of dietary intervention in the whole group revealed a significant decrease in TNSS and each symptom assessed separately, and the L-K score. The group was further divided into two subgroups based on the distance between NSAID intake and the beginning of symptoms: patients with immediate (n = 9; 22.5%) or non-immediate (n = 31; 77.5%) symptoms. The absolute change in nasal obstruction, itching, TNSS, and L-K scores were significantly higher in patients with immediate than with non-immediate symptoms. Conclusion: Results of the study indicate that patients with N-ERD and immediate symptoms may clinically benefit more from an LSD as an additional therapeutic option than patients with non-immediate symptoms.