Intranasal trigeminal function in chronic rhinosinusitis: a review

Expert Rev Clin Immunol. 2023 Jul-Dec;19(8):921-938. doi: 10.1080/1744666X.2023.2231149. Epub 2023 Jul 10.

Abstract

Introduction: Chronic rhinosinusitis (CRS) affects 5-12% of the general population with significant effects on quality of life. Chronic inflammation also seems to affect intranasal trigeminal sensitivity.

Areas covered: A systematic literature search was done in Scopus, Web of Science, and PubMed in February 2023. The review addressed intranasal trigeminal function in patients with CRS and summarized current knowledge on trigeminal function as it relates to the symptoms, assessment, and treatment of CRS.

Expert opinion: Olfaction and trigeminal function are synergistic and this interaction may contribute to trigeminal dysfunction in CRS. Aside from anatomic blockage through polypoid mucosal changes, trigeminal dysfunction may affect the perception of nasal obstruction in CRS. Upregulated immune defense mechanisms leading to damage of nerve endings, changes in nerve growth factor release or other mechanisms may be responsible for trigeminal dysfunction in CRS. Since the pathophysiology of trigeminal dysfunction in CRS is poorly understood, current treatment recommendations are directed toward the therapy of CRS as an underlying cause, although the effect of surgery and corticosteroids on trigeminal function remains unclear. A standardized and validated trigeminal test that is accessible and easy to use in clinical settings would be beneficial for future studies.

Keywords: chemesthesis; chemosensory; chronic rhinosinusitis; nasal polyps; nose; olfaction; trigeminal.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Adrenal Cortex Hormones / therapeutic use
  • Chronic Disease
  • Humans
  • Nasal Polyps* / drug therapy
  • Quality of Life
  • Rhinitis* / drug therapy
  • Sinusitis* / drug therapy

Substances

  • Adrenal Cortex Hormones