title: Patents and Recent Innovations in Topical Membrane Therapy of Refractory Rhinosinusitis.
abstract: Chronic Rhinosinusitis (CRS), one of the commonest chronic inflammatory disorders, is encountered daily in all healthcare settings. In its refractory form, CRS seems to prevail over most up-to-date surgical interventions and systemic medical remedies, owing to our poor understanding of its perplexing pathophysiology. Although several systemic influences impinge on the progression of inflammation, the true interplay between offensive and defensive factors takes place on-site, i.e. across the sinonasal epithelial coating. Therefore, current treatment strategies shift the weight of CRS management toward topical modalities, which combine the benefits of surgical approach with the healing effect of conventional medications. An explosive emergence of relevant patents is still in progress, emphasizing the need for classification and comparison. Novel delivery methods of medications into the sinus cavities include modifications of traditional rinses, state-of-the-art nebulizing devices, and the revolutionary concept of sustained drug application utilizing carrier gels or nasal implants. As far as the introduction of new medications is concerned, recent patents propose alterations to the physical and chemical properties of irrigating solutions, as well as the local use of antiseptics, hydragogues, and anti-biofilm agents. This review focuses on the local pathophysiologic events of CRS and the most exciting innovations regarding its topical management.
authors.affiliation: Maryland Nose & Sinus Center Rhinology Fellowship Program; Otolaryngology-Head and Neck Surgery, The Union Memorial and Sinai Hospitals in Baltimore, Address: 201 East University Parkway, Baltimore, MD 21218, USA. ashikani@gmail.com.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Shikani
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Kourelis
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000737:chemistry; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000737:chemistry; D002626:Chemistry, Pharmaceutical; D002908:Chronic Disease; D004059:Diffusion of Innovation; D004304:Dosage Forms; D016503:Drug Delivery Systems; D055808:Drug Discovery; D004335:Drug and Narcotic Control; D006801:Humans; D009297:Nasal Mucosa / Q000187:drug effects* / Q000276:immunology; D010330:Patents as Topic; D012220:Rhinitis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D012852:Sinusitis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D004304:Dosage Forms; D013256:Steroids