Managing Chronic Rhinosinusitis with Nasal Polyps in the Elderly: Challenges and Solutions

Abstract

The proportion of the population over 65 years old continues to grow. Chronic rhinosinusitis is common in this population and causes a reduction in quality of life and an increase in health care utilization. Diagnosis of chronic rhinosinusitis with nasal polyps follows the same principles for elderly patients as in the general population, but the elderly population presents some diagnostic challenges worth considering. Presbynasalis, the anatomic and functional changes of the nose and paranasal sinuses associated with aging must be accounted for when caring for these patients. In addition, polypharmacy and other medical issues that can cause similar symptoms must be considered. Medical therapy is generally similar to the general population but with additional concerns given the propensity for geriatric patients to be on multiple medications and to suffer from multiple medical issues. Sinus surgery should be considered following the same indications as in the general population. While some authors have found higher complication rates in endoscopic sinus surgery, others have found higher rates of success. As always, the risks of surgery must be considered with the possible benefits on a patient-to-patient basis.

Waktu Laju Transportasi Mukosiliar Hidung pada Penderita Rinosinusitis Kronik di RSU Cut Meutia

“…Dengan seiring bertambahnya usia, produksi protein S100 menurun yang menyebabkan proliferasi sel, perbaikan, dan pertahanan epitel menjadi terganggu dan menyebabkan peningkatan risiko kolonisasi mikroba abnormal setelah terjadinya peradangan kronik sehingga dapat menyebabkan rinosinusitis kronik (19).…”

Correlation among post-surgery recurrence of CRSwNP and TCM syndromes and tissue inflammatory cell infiltration type: a study protocol

“…Due to the similar degree of improvement in endoscopic scores and quality-of-life indicators among patients undergoing chronic sinusitis surgery at different age groups, or without exceeding the minimum clinically important differences [19][20][21], this study did not consider further age stratification factors. All participants are diagnosed with CRSwNP.…”

Effectiveness of Dupilumab in the Treatment of Adult and Older Adult Patients with Severe, Uncontrolled CRSwNP

“…According to the latest projections, the proportion of the population that is over 65 in Western countries is growing, and it is estimated that over 20% of the population will be over 65 by 2050 in these areas [ 1 ]. As the proportion of the population over 65 is increasing, so are the challenges in diagnosing and managing some pathologies in elderly adults.…”

“…Chronic rhinosinusitis with nasal polyps (CRSwNP) is known to ultimately reduce the quality of life of affected patients. The incidence of CRSwNP, which is higher in men, is reported to be approximately 1–4% of the general population, with ~5% of elderly adults suffering from CRSwNP [ 1 ] CRSwNP’s disease course is highly variable as some patients present with rare mild symptoms, whereas in others these are frequent, causing discomfort and affecting quality of life.…”

“…Causing nasal obstruction, nasal discharge, loss of taste and smell, toothache, ear pain, and or headaches, generally speaking, CRSwNP reduces patients’ overall health and quality of life [ 1 , 2 ]. According to international guidelines, diffuse, bilateral CRS should be treated with local corticosteroids and saline irrigations, but these need to be delivered to compliant patients using appropriate techniques.…”