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Role of probiotics in chronic rhinosinusitis: a systematic review of randomised, controlled trials

Published online by Cambridge University Press:  31 March 2023

P Fong Open the ORCID record for P Fong [Opens in a new window] ,
K Lim ,
A Gnanam  and
T Charn
P Fong
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sengkang General Hospital, SingHealth, Singapore, Singapore
K Lim
Affiliation:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
A Gnanam
Affiliation:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
T Charn*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sengkang General Hospital, SingHealth, Singapore, Singapore
*
Corresponding author: Tze Choong Charn; Email: entdrcharn@gmail.com
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Abstract

Objective

This review evaluated the safety profile and efficacy of probiotics in chronic rhinosinusitis and was registered with Prospero (Centre for Reviews and Dissemination number: 42020193529).

Method

Literature databases were searched through inception to August 2022. Randomised, controlled trials exploring adjunctive probiotics in adult chronic rhinosinusitis patients were included. From 948 records screened, 4 randomised, controlled trials were included.

Results

Probiotics-associated adverse effects comprised epistaxis and abdominal pain. No reduction in Sino-Nasal Outcome Test values before 4 weeks (p = 0.58) or beyond 8 weeks (p = 0.08) of treatment or reduction of severe symptom frequency (p = 0.75) was observed. Symptom relapse in probiotic-treated patients was significantly lower across all timepoints (p = 0.045). Lower sinusitis relapse risks during treatment (risk ratio = 0.49; p = 0.019) and 8 months post-treatment (risk ratio = 0.56, p = 0.013) were observed. Probiotics demonstrated potential in improving Sino-Nasal Outcome Test symptom subscales, including sleep, psychological and rhinology subscales.

Conclusion

The optimal mode of probiotic administration, treatment duration and target patient subgroups requires further study to evaluate the utility of probiotics.

Keywords

Probioticsreviewrhinitissinusitis
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 12 , December 2023 , pp. 1300 - 1311
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

*

co-first author.

Tze Choong Charn takes responsibility for the integrity of the content of the paper

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