Despite the fact that Acute Rhinosinusitis (ARS) shows an increasing prevalence in European countries, it remains enigmatic in terms of its physiopathology, reliability of diagnosis or even in elaborating an effective and optimal treatment strategy.

Perhaps even more surprising is the fact that direct and indirect costs for one episode of ARS treatment are extremely high, approximately €800 according to the PROSINUS study. Considering that more than 20m Europeans are deemed to be affected at least once a year by an episode of ARS, that brings the cost of ARS treatment for the Health Authorities to more than €16bn per year.

The main cause of ARS is a post-viral infection, and all lecturers agreed that ARS is an inflammatory disease, with the aim of treatment being symptom relief, thereby allowing sinus drainage and ventilation.

But how can ARS be diagnosed? An interesting study presented shows that practitioners essentially use the same diagnosis criteria as the EP3OS study recommendations. That is to say, symptoms are the basis for Rhinosinusitis diagnosis, while X-ray and CTscan are not recommended at daily practice.

Moving on to available treatments, European Position paper on Rhinosinusitis and Nasal Polyps 2007 (EP3OS) guidelines recommend use of oral antibiotics only for the most complicated cases, where high fever and pain are present.

In most patients, inflammation can be controlled if treated by topical corticosteroids. However, as , high doses of corticosteroids are required to achieve a significant effect and, moreover, EMA have not approved a Rhinosinusitis indication for them.

Of particular note is the fact that half of the prescriptions for antibiotics in European countries

are for Upper Respiratory Tract Infection. Unfortunately, antibiotics do not seem to prevent ARS complications. A Cochrane Review on antibiotics in ARS provides quite an indicative statistic: we have to treat 7 patients to, probably, make one better slightly earlier.

Increasingly, patients from around the world are looking for safer, more effective Products for managing their disease. Could that be one of the reasons why Cyclamen europaeum L. extract is being administered more and more to relieve the symptoms of ARS sufferers?

A number of studies, some of them highly pioneering, have been carried out to demonstrate the clinical effectiveness of Cyclamen europaeum L. extract. Said efficacy is mainly due to its high saponin content. Once sprayed into the nostrils, saponins, in addition to a

local surfactant effect, stimulate the nervous system of the nasal mucosa inducing both a nociceptive and cholinergic response, hence stimulating glandular secretion and cilia movement.

So, , there is finally an innovative and effective treatment option for Acute Rhinosinusitis.

Cyclamen europaeum L. extract will clean and drain mucus away from the sinonasal area in a physiological way. One final point, but by no means of lesser importance, we have heard how Cyclamen europaeum L. extract has generated some very positive feedback from patients.