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Open research questions in Sinusitis and nasal conditions

53 unresolved questions extracted from the limitations and future-work sections of 717 Sinusitis and nasal conditions papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Nevertheless, several limitations of this study should be ac- knowledged. In light of these limitations, future studies are warranted to validate our findings in vivo, to determine whether EMT is mediated through the IL-5/JAK2/STAT5 signaling pathway using targeted inhibition approaches, and to confirm these effects using primary human eosinophils rather than eosino- phil-like cells derived from HL-60.

    IL-5Rα–Mediated Signaling in Eosinophils May Contribute to the Epithelial–Mesenchymal Transition in Eosinophilic Chronic Rhinosinusitis With Nasal Polyps · 2026 · DOI

  • However, whether gd T cells actively contribute to disease pathogenesis or represent a response to ongoing inflam- mation or broader tissue remodelling remains to be determined in the future. The study is limited by a relatively small sample size, particularly for RT-qPCR measurements, and by a predominance of male patients, warranting cautious interpretation of our findings.

    Progressive γδ T cell remodelling is associated with type-2 inflammation in eosinophilic chronic rhinosinusitis with nasal polyps · 2026 · DOI

  • The limitations of this study include the retrospective design and the small sample size, which likely restricted the statistical significance of some correlations between clinical characteristics or biomarkers. Nonetheless, our analysis is valuable as it highlights trends near statistical significance, which could be further investigated in larger sample sizes.

    Benralizumab is effective in severe asthma with CRS, regardless of demographic and clinical basal outcomes · 2026 · DOI

  • Background: Emerging evidence indicates that the succinate–succinate receptor 1 (SUCNR1) axis promotes metabolic reprogramming and plays a pivotal role in shaping immune responses, yet the contribution of the succinate–SUCNR1 axis to eosinophilic inflammation of the nasal mucosa remains poorly understood.

    Succinate–succinate receptor 1 axis amplifies eosinophilic inflammation in nasal mucosa · 2026 · DOI

  • The duration of follow-up in this study might not have been sufficient to assess the long-term effects and sustain- ability of FAP as a complementary therapy. CRS is a long- term condition, and the effectiveness of the therapy may vary over extended periods. The bacterial profile in participants with CRS can be highly heterogeneous, which might affect the generalisability of the bacterial analysis. Variations in bacterial strains and their susceptibility to fusidic acid might influence treatment outcomes.

    Effect of fusidic acid phonophoresis as a complementary therapy in chronic rhinosinusitis: a randomised clinical trial · 2026 · DOI

  • the heterogeneity of patients included in the study as well as the disease processes them- selves. Patients were stratified by ICD 9/10 diagnosis code for subgroup analysis without inclusion of radiographic or endoscopic data. Although multivariable logistic regression controlled for time, visit number, and demographic fac- tors, certain treatment details and other potential modify- ing or confounding variables may have been excluded. It is likely that visit number is correlated with ongoing, or step- up treatment, but our sample includes some patients who International Journal of Biometeorology (2026) 70:165 1 3 165 Page 8 of 10 made follow-up visits after discontinuing a treatment, and we cannot account for these cases in our analysis. We also do not account for diversity of treatment modalities (i.e. medical, surgical, environmental). We adjusted for repeated measures, but unmeasured confounders such as concur- rent upper-respiratory infections or indoor exposures could contribute residual correlation. Sensitivity analyses exclud- ing same-day multiple diagnoses produced nearly identical results (not shown). Although we believe the total number of surveys provides a sufficiently robust sample to support our overall results, it is likely that the subdomain results are underpowered and should therefore be considered with caution. Patient home address was used for inclusion and although SNOT-22 scores were measured during in-person clinic visits requiring proximity to weather monitors on day of measurement, methods do not guarantee proximity on lag days or measure individual patient microclimates. This is a common limitation of environmental studies that do not include wearable monitors; however, the included geogra- phy, covering 736 square miles, is meteorologically small, ensuring weather variability on a given day is minimal across the study region. Other limitations are inherent to the SNOT-22 survey. Firstly, SNOT-22 items are sensitive, not specific, and may detect a host of other neurologic, head and neck, sleep, or mood disorders with potentially variable association with weather (La Mantia et al. 2023). Symptom overlap between sinus disease and migraine, for example, is well described as both implicate the trigeminal nerve (Eross et al. 2007; Gryglas 2016; Levine et al. 2014). Climate has also been proposed to play a role in migraine attacks and although the SNOT-22 is written to detect ‘symptoms and social/ emotional consequences of your nasal disorder,’ patients may have trouble differentiating overlapping symptoms from distinct disease states (Tepper 2004; Gryglas 2016). Furthermore, the survey instructs the patient to ‘rate your problems, as they have been over the past two weeks.’ This allows symptoms prior to measured weather exposures to potentially enter our analysis which may limit internal validity. However, the strongest detected effect being pres- ent on day of SNOT-22 completion that tends to weaken as a function of lag supports our conclusions. Finally, this study was based on a long time series of data available from a single site with a modest local population. Examination of comparable data from locations with different climates and more dense populations would be useful to test generaliz- ability of these findings. Future work could include patient reported symptom measures specifically designed to optimally capture effects of interest. Using customized measures may limit exter- nal validity, however, and the SNOT-22’s prior valida- tion and widespread use rendered it a useful tool for this retrospective study. Directions for future work include a comparable examination in different climates or geogra- phies including heavily populated urban centers with higher pollution levels, incorporating wearable technology to more reliably capture experienced weather and control for experi- enced pollutant levels, and further elucidating mechanisms behind the effects of climate on sino-nasal symptomatology.

    Climate and sino-nasal symptoms · 2026 · DOI

  • Early radiological assessment in particular by CT scanning is strongly considered in patients with sinusitis who present with ocular symptoms of swelling, pain or visual disturbance. Greater Kumar et al. International Journal of Current Pharmaceutical Review and Research 57 International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 education of primary care colleagues in early signs and is important to ensure no delay in referral. symptoms of orbitial complications Further, multicentric studies with longer follow-up are recommended in order to study the risk factors, regional patterns and long-term sequel of orbital complications of sinusitis.

    A Descriptive Study of the Patients with Orbital Complication of Acute and Chronic Sinusitis · 2026 · DOI

  • orbital complications, particularly with visual symptoms the suspected that in Kumar et al. International Journal of Current Pharmaceutical Review and Research 56 International Journal of Current Pharmaceutical Review and Research e-ISSN: 0976-822X, p-ISSN: 2961-6042 or reduced ocular movements cellulitis), CT imaging is mandatory. (with/without Management Strategies and Clinical Outcomes: The majority of patients in this study demonstrated a positive response to conservative therapy with intravenous antibiotics, nasal decongestants and supportive management. Surgical treatment, which involved endoscopic sinus surgery and abscess patients with drainage, was performed in few had insufficient medical treatment response or abscess formation. There was a good result in most of the patients, long-term sequelae. These findings are consistent with the observations, emphasizing the role of prompt diagnosis and and multidisciplinary ophthalmologist). surgeon (ENT care Comparison Table Present Study vs.

    A Descriptive Study of the Patients with Orbital Complication of Acute and Chronic Sinusitis · 2026 · DOI

  • PDT may play a role in immunomodulation and mucosal healing mechanisms that may translate to ENT applications such as chronic tonsillar or oropharyngeal inflammation, requiring further investigation.

    Photodynamic Therapy in Otorhinolaryngology: Current Evidence, Clinical Applications and Future Perspectives · 2026 · DOI

  • PDT applications are documented more extensively in dental and oral medicine than in strict ENT practice, and future research should clarify its specific role in otorhinolaryngology.

    Photodynamic Therapy in Otorhinolaryngology: Current Evidence, Clinical Applications and Future Perspectives · 2026 · DOI

  • Complex anatomical geometries in ENT can cause shadowing and poor light delivery, leading to inadequate photosensitizer distribution; advanced technologies could significantly improve treatment accuracy and lower phototoxicity.

    Photodynamic Therapy in Otorhinolaryngology: Current Evidence, Clinical Applications and Future Perspectives · 2026 · DOI

  • There is substantial heterogeneity in light wavelengths, photosensitizers, doses, and treatment intervals used across PDT studies, making them difficult to compare.

    Photodynamic Therapy in Otorhinolaryngology: Current Evidence, Clinical Applications and Future Perspectives · 2026 · DOI

  • While heterogeneity of study settings and protocols limits formulating universal guidelines for PDT in otorhinolaryngology, the beneficial effects correspond to various disease entities.

    Photodynamic Therapy in Otorhinolaryngology: Current Evidence, Clinical Applications and Future Perspectives · 2026 · DOI

  • Neverthe- less, there is scope for further clinical and experimental research into the frequently cited CHM formulations and their ingredients to inform clinical decision making and their mechanisms of action could be explored in animal models to identify future therapeutics.

    Chinese herbal medicines for rhinosinusitis: a text-mining study with comparisons to contemporary research and clinical guidance · 2025 · DOI

  • One limitation of this text mining study is that we used a single source for literature. While this was the largest collection available, it did not include all books written in pre-modern China, so we might have missed some less significant historical publications relevant to RS. Some reports of conditions similar to RS may not have used any of the search terms we identified, even though we used multiple search terms, so these may have been missed. Although the citations from the classical literature referred to conditions similar to the modern conception of RS, the criteria for similarity were based on classi- cal terminology for which the scope of meaning is likely to have been different to current usage. Therefore, it remains unclear whether a nasal disorder referred to in a classical citation would now be classified as RS. Moreo- ver, we could not reliably distinguish between ARS and CRS. We assume that CRS was more likely in the classical citations since classical books tend to focus on more seri- ous conditions, but this remains an assumption. There were few studies of ARS in the systematic reviews, so comparisons between classical results and clinical trial results were not feasible for ARS. In the comparisons, we used a sample of modern TCM specialist textbooks based on availability. There was no deliberate selection of books, but as this was not a ran- dom sample of all possible books, bias is a possibility. Analyses were descriptive based on frequency, rank and overlap between data sets. Higher frequency in a data set is an indication of usage or popularity and should not be misconstrued as indicating greater effectiveness of a formula or herbal ingredient for RS management. Simi- larly, presence or absence of an item in multiple data sets is not a measure of effectiveness. Our selection of Piper longum for a mini review was based on its frequency alone, and other lower frequency CHMs may have shown stronger evidence.

    Chinese herbal medicines for rhinosinusitis: a text-mining study with comparisons to contemporary research and clinical guidance · 2025 · DOI

  • CONCLUSION: The evidence that AMOs cause chronic sinusitis and FESS failure is insufficient and cannot explain the presence of AMOs in healthy individuals or children.

    Evaluation of the relationship between the presence of an accessory maxillary ostium and the presence and types of nasal septum deviation: A computed tomography study · 2024 · DOI

  • NO’s role in the upper airway disease is not completely known, but it appears to act like a first-line host defence agent, maintaining the sinuses sterile due to its antiviral and bacteriostatic properties and by increasing mucociliary clearance.

    The role of nitric oxide in chronic rhinosinusitis · 2015 · DOI

  • Its pathology, however, still remains unclear and researchers focus more and more on the role of nitric oxide (NO), a free radical produced in normal conditions by the paranasal sinuses epithelium in healthy patients, in the development of this disease.

    The role of nitric oxide in chronic rhinosinusitis · 2015 · DOI

  • In the literature there are only a few reports on invasive sinusitis in people after heart transplantation, in the opposed to many retrospective series studies of several hundred patients suffering from chronic sinusitis in the course of leukemia or a certain number of papers concerning the complications of sinuses after kidney and – less often – liver transplantation.

    Powikłania oczodołowe w przebiegu leczenia grzybiczego zapalenia zatok u pacjenta po przeszczepie serca · 2014 · DOI

  • Antibiotic therapy seems to accelerate resolution of ARS in children but whether an acceleration of improvement of the antimicrobial symptoms with antibiotics in these children is worth the increased risk of resistance remains to be determined.

    Leczenie zapalenia zatok przynosowych u dzieci · 2012 · DOI

  • If acute maxillary sinusitis is defined as positive radiographs or positive sinus aspiration cultures, limited evidence indicates that therapy with either amoxicillin or penicillin for seven to 14 days is modestly effective.

    How Should We Treat Acute Maxillary Sinusitis · 2001

  • Hence, further study into any correlation between HP infection and CRS is required with a larger sample size.

    A study to determine the presence of helicobacter pylori in patients with chronic rhinosinusitis · 2026 · DOI

  • Although many studies have examined the pathophysiology of CRS, the role of reactive oxygen species (ROS) remains incompletely understood.

    Role of Reactive Oxygen Species in Chronic Rhinosinusitis: A Narrative Review · 2026 · DOI

  • These contradictory results raise the question of whether mucosal thickening should be viewed strictly as a pathological consequence or, in some contexts, as a transient and self-limiting physiological response to surgery.

    Impact of Le Fort I Osteotomy on Maxillary Sinus Mucosal Thickness: A Retrospective CT Study · 2026 · DOI

  • Glucocorticoids serve as anti-inflammatory therapies, yet how they modulate chemokine networks has not been systematically evaluated using integrative approaches.

    Dexamethasone modulates chemokine networks in murine type 2 inflammation model: Integration of network pharmacology and in vivo validation · 2026 · DOI

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53 open questions have been extracted from the limitations and future-work passages of 717 Sinusitis and nasal conditions papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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