The role of Pistacia lentiscus oil in the prevention of chronic rhinosinusitis recurrence during long-term therapy: a retrospective observational case-control study

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Introduction Chronic rhinosinusitis (CRS) is a prevalent inflammatory disease of the upper airways, frequently characterized by recurrence and impaired quality of life. Persistent inflammation and bacterial biofilms contribute to disease chronicity. Topical plant-derived therapies may offer a preventive strategy in long-term CRS management. This study evaluated the effectiveness of a Pistacia lentiscus–based nasal medical device in reducing the impact of CRS recurrence on patients' daily life. Methods In this retrospective, observational, single- center case-control study, 100 adult patients with chronic rhinosinusitis (CRS) and recurrent disease were identified and included from clinical records. Patients were stratified according to prior exposure to nasal drops containing ultra-fractionated Pistacia lentiscus oil in addition to isotonic saline nasal irrigation, or to isotonic saline nasal irrigation alone, according to routine clinical practice. All patients had undergone a 12-month follow-up regimen with assessments available at baseline, 30 days, and 12 months. The primary outcome was symptom severity measured using the Sino-Nasal Outcome Test (SNOT-22). Secondary outcomes included nasal cytology parameters, biofilm presence, nasal discharge, bacterial elements, supranuclear stria, and ciliary motility. Results Of the 100 identified subjects, 92 were included in the final analysis due to loss to follow-up. In the exposed group, SNOT-22 scores showed a 40.6% reduction after the first month, compared with a 7.8% reduction observed in the control group ( p < 0.001). Only patients exposed to Pistacia lentiscus oil demonstrated statistically significant reductions over time in nasal discharge ( p < 0.005), biofilm presence ( p < 0.005), and bacterial elements ( p < 0.05), while no significant changes were observed in the control group for these parameters. Ciliary motility remained unchanged in both groups across the study period. Discussion Overall, within the limits of this retrospective case-control design, patients exposed to Pistacia lentiscus oil in addition to standard saline irrigation showed greater improvement in patient-reported symptoms and selected cytological markers compared with patients treated with saline irrigation alone.

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