Sinonasal Inflammation Manifestations and the Role of the Autonomic Nervous System

Abstract

Introduction: Sinonasal inflammatory manifestations such as nasal congestion, discharge, and sneezing, along with sinusitis-related complaints, can be explained with respect to changes in the autonomic nervous system known since the time of the great Greek physician who served the Roman emperors. Scientific discussion began during the 1950s with one publication by Hilger titled autonomic dysfunction in otolaryngology. Despite recent advances in technology, our understanding of the exact mechanisms involved in changes in the autonomic nervous system during sinonasal inflammation due to exposure to inflammatory agents such as allergens, viral, infection, and exposure to physical inflammatory agents is limited.
Methods: The author performed a detailed online data search for publications on PubMed, Medline, Google Search, and Scopus platforms between 1950-2022. During the search, the author focused on sinonasal inflammation, common manifestations, and the relation of patient complaints to changes in the autonomic nervous system.
Result: Still, we are far from clearly knowing the reason behind refractory and chronic rhinitis; cases of sinusitis. The association of autonomic nervous system changes and manifestations of rhinosinusitis knowledge may help the treating physician plan a newer form of treatment for resistant cases.
Conclusions: A better understanding of the autonomic nervous system disturbance will help in planning better methods of treatment for chronic and resistant sinonasal inflammatory diseases, because they affect the individual and the community in all ways of life. This understanding can help to develop alternative methods to treat cases of refractory rhinosinusitis by using new treatment methods such as botulin toxin, mindfulness techniques, and cognitive behavioural therapy.