Section: 
Rhinology issues
Rhinology issuesDetermining management and treatment tactics for fractures of superior wall of maxillary sinus in children
D. I. Konstantinov (1), M. A. Erashov (2), O. A. Denisova (3), M. M. Polunin (4), E. Yu. Radtsig (5), Yu. L. Soldatskii (6), A. A. Polyakov (7), S. R. Edgem (8)
(1), (4), (5) Pirogov Russian National Research Medical University, Moscow, 117997, Russian Federation, (1), (2), (3), (4), (5), (6), (7), (8) Morozov Children’s City Clinical Hospital, Moscow Department of Health, Moscow, 119049, Russian Federation
UDK: УДК 616.216-001.5-089.15-053.2
DOI: https://doi.org/10.18692/1810-4800-2026-2-25-34
ABSTRACT
Abstract. Currently, biological therapy is an innovative and highly effective approach in the treatment of severe, non-controlled chronic rhinosinusitis with nasal polyps (CRSwNP) associated with T2-inflammation by standard treatment methods. The article presents a long-term follow-up of a patient who, 1 year after the start of targeted biological therapy with dupilumab, stopped treatment on his own because of complete relief of symptoms of CRSwNP. Within 2 years after the abandonment of biological therapy, the patient had a persistent clinical remission in relation to the symptoms of CRSwNP, confirmed by the results of a video endoscopy of the nasal cavity and data of computed tomography of the paranasal sinuses. The trigger for the polyp recurrence more than 2 years later was presumably an acute respiratory viral infection. Subsequently, because of the lack of response to basic therapy, dupilumab treatment was resumed. This clinical observation shows that even prolonged remission after discontinuation of genetically engineered biological therapy (GEBT) does not eliminate the risk of late recurrence, and viral infections can trigger the resumption of T2-mediated inflammation. The hypothesis of «tissue immunological memory,» previously proposed in studies of dupilumab in patients with atopic dermatitis, may be of particular importance in triggering polyp recurrence. These findings highlight the need for personalized approaches to the initiation and discontinuation of GEBT in CRSwNP, an in-depth study of the criteria for a super response to treatment, and the importance of long-term patient monitoring even after achieving sustained remission.
Publication date:
15.04.2026
Keywords:
chronic rhinosinusitis with nasal polyps, recurrence, dupilumab, long-term remission, withdrawal For citation:
Konstantinov D. I., Erashov M. A., Denisova O. A., Polunin M. M., Radtsig E. Yu., Soldatskii Yu. L., Polyakov A. A., Edgem S. R. Determining management and treatment tactics for fractures of superior wall of maxillary sinus in children. Russian Otorhinolaryngology. 2026;25(2):25-34. (In Russ.) https://doi.org/10.18692/1810-4800-2026-2-25-34