Hot topics in pediatric chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is a heterogeneous chronic inflammatory condition of the paranasal sinuses and nasal passage. CRS may significantly compromise patients’ quality of life and may represent an alert sign for other underlying systemic diseases. CRS is now considered an umbrella diagnosis for several diseases with distinct mechanistic pathways (endotypes) and variable clinical presentations (phenotypes). Therefore, it is necessary to integrate medical and surgical skills and evaluate and treat the patient through a multidisciplinary approach. Only two biologicals (omalizumab and dupilumab) are approved in adults with severe CRS with nasal polyps. Clinical trials conducted in children and adolescents are needed to reinforce the strength of available efficacy and safety data of biologic therapies in the adult population and children with CRS with nasal polyps.