Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nasal passages and sinuses, often characterized by nasal congestion, loss of smell, facial pressure, and nasal discharge. Conventional treatments, such as corticosteroids and endoscopic sinus surgery (ESS), often provide only temporary relief, with frequent recurrence of symptoms. For patients with severe, refractory CRSwNP, biologic therapies have emerged as a promising treatment option. This review evaluates the efficacy and safety of biologic treatments for CRSwNP, including dupilumab, mepolizumab, and omalizumab. We analyze clinical trial data, patient-reported outcomes, and the latest research on the use of biologics in CRSwNP management. Our findings confirm the efficacy of biologics in treating CRSwNP, showing consistent improvements in both clinical and patient-reported outcomes. The use of biologics resulted in a significant reduction in nasal polyp size, improved nasal congestion, and reduced the need for further surgery or systemic corticosteroids. Moreover, patients experienced an improved sense of smell and a better quality of life. This review also includes a comparative analysis of the three biologics, highlighting their efficiency and potential risks. The findings suggest that dupilumab may be the most effective biologic therapy for CRSwNP, showing superior efficacy compared to mepolizumab and omalizumab in reducing nasal polyp size and improving nasal congestion. The article provides valuable insights for healthcare providers and patients considering biologic therapy for CRSwNP, emphasizing the importance of personalized treatment decisions based on individual patient factors, including disease severity, comorbidities, and preferences.

The term chronic rhinosinusitis (CRS) comprises of an assortment of diseases that share a common feature: inflammation of the sinonasal mucosa. The phenotype classification of CRS, based on the presence of polyps, has failed to offer a curative treatment for the disease, particularly in refractory cases. Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging entity. Researchers have made efforts trying to characterize subtypes of the disease according to the endotypes, which are delineated by different immunological pathways, using biomarkers. Even if the inflammatory processes controlling CRSwNP are not fully understood, data suggested that the disease associated with a type 2 inflammatory mechanisms can be also linked to the type 1 or type 3 pathomechanism, being highly heterogeneous. Biomarkers for CRSwNP are proposed, such as: eosinophil count, cytokines, metalloproteinases, bitter and sweet taste receptors, and the nasal microbiome. For endotyping to be clinically applicable and simply determined, biomarkers referring to the intrinsic biomolecular mechanism still need to be found. Precision medicine is becoming the new standard of care, but innovative therapies such as biologics may be rather challenging for the clinicians in their daily practice. This new approach to CRSwNP implies patient selection and a simple algorithm for deciding the right treatment, easy to implement and adjust. Our review points out the ongoing new research on the pathophysiology of CRSwNP, biomarkers and treatment opportunities. It allows clinicians to keep abreast of current evidence-based knowledge and to individualize the management of CRSwNP, especially in refractory cases.

Background and Objectives: This study aims to establish the sheep head as a viable anatomical model for training in functional endoscopic sinus surgery through comprehensive anatomical examination and training-based assessment of participants’ satisfaction. Materials and Methods: Participants were divided into three groups according to their prior experience in endoscopic sinus surgery; in total, 24 participants were included. Each participant in the study was assigned to perform the designated procedures on a single sheep’s head. Following the completion of the procedures, each participant was provided with a 14-item comprehensive satisfaction questionnaire with a scale attributed from 1 to 5. The normality of distribution was checked by applying the Shapiro-Wilk Test. The Kruskal–Wallis test was applied to compare study group sentiment of agreement towards individual procedures. Results: No significant differences were noted between the answers of the different groups. For the resident group, the average satisfaction score was 4.09 ± 0.54; junior specialist group 4.00 ± 0.55; for the senior specialist group overall satisfaction average score was 4.2 ± 0.77. Conclusions: The sheep’s head can be successfully used for learning and practicing manual skills and the use of instruments specific to functional endoscopic sinus surgery. Moreover, the sheep head model can be used for training in other diagnostic or surgical procedures in the field of otorhinolaryngology, such as endoscopy of the salivary glands, open laryngotracheal surgery, or in otologic surgery, but also in other different surgical fields such as neurosurgery, ophthalmology or plastic surgery. Despite the differences between the ovine model and human anatomy, it provides a resourceful and cost-effective model for beginners in endoscopic nasal surgery.

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly affects patients' quality of life, impacting both physical and psychological well-being. This study investigated the potential role of resilience in coping with CRSwNP and its relationship to disease severity and cellular proliferation. Methodology Between July 1, 2021, and June 30, 2022, 30 patients diagnosed with CRSwNP were enrolled in a study at Cardiomed Hospital in Cluj-Napoca, Romania. Resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), while disease severity was evaluated through patient-reported outcomes (Sino-Nasal Outcome Test (SNOT-22)) and objective measures (Lund-Mackay score). Ki-67 expression was analyzed as a marker of cellular proliferation within nasal polyps. Results No significant correlation was observed between resilience and either SNOT-22 scores or Ki-67 expression. However, a strong positive correlation was found between SNOT-22 scores and Lund-Mackay scores, indicating that patients with more severe symptoms also exhibited greater objective disease burden. In addition, a moderate positive correlation was identified between Ki-67 expression and Lund-Mackay scores, suggesting a potential link between cellular proliferation and disease severity. Conclusion These findings suggest that resilience may not directly influence symptom severity or cellular proliferation in CRSwNP. Further research with larger sample sizes and longitudinal designs is needed to elucidate the complex interplay between resilience, disease pathophysiology, and patient outcomes in CRSwNP. This will ultimately inform the development of more targeted and effective interventions to improve the quality of life for individuals with this chronic condition.