Trends on rhinosinusitis diagnosis and treatment.

A growing interest in rhinosinusitis in recent years resulted in two European Position Papers in Rhinosinusitis and Nasal Polyposis (EP3OS) documents, published in 2005 and 2007, respectively. The latter is intended to be a state-of-the art review for specialists and general practitioners, updating the current knowledge on rhinosinusitis and nasal polyposis, proposing the guidance for definitions and outcome measurements in research and providing an evidence-based review of the available treatments. The present article briefly discusses the guidelines for acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) diagnoses, as well as treatment recommendations provided by that document. Recent, epidemiological PROSINUS study of ARS, carried out in Spain, is also briefly reviewed, with special emphasis on Cyclamen europaeum extract use in ARS treatment. A new treatment approach is proposed, based on Cyclamen europaeum extract use in ARS and in the postoperative management of patients with CRS and nasal polyps undergoing endoscopic sinus surgery, which is associated with clinically confirmed, significant improvement of patients' symptoms, nasal endoscopic signs and patient satisfaction in comparison to saline. These results are thought to be connected with nasal drainage-facilitating and paranasal sinuses-cleaning activities of the extract.