Nasal nitric oxide is a significant biomarker for diagnosing and treating sinonasal inflammatory diseases including chronic rhinosinusitis, acute bacterial rhinosinusitis, and allergic rhinitis, as deciphered from a review published in Annals of Otology, Rhinology & Laryngology. This study aimed to analyze the literature on nasal nitric oxide and its clinical applicability to alleviate various sinonasal disorders.

PubMed database was comprehensively explored to include relevant articles on nasal nitric oxide and sinonasal  inflammatory diseases. Following the selection of manuscripts, full-text reviews were carried out for synthesizing current understandings of nasal nitric oxide and its applications to several sinonasal diseases.

Overall, 79 relevant studies from an initial 559 articles were recognized. Nasal nitric oxide was found to decrease in chronic rhinosinusitis  and acute bacterial rhinosinusitis, particularly in cases with nasal polyps. While allergic rhinitis was linked with an increase in nasal nitric oxide, the levels of nasal nitric oxide were also reported to be lower in allergic rhinitis cases with greater symptom severity. Obstruction of paranasal sinuses was speculated to be a significant variable in the association between sinonasal diseases and nasal nitric oxide.

Treating these diseases seems to impact nasal nitric oxide via curtailment of inflammatory disease burden and also alleviation of sinus obstruction. In recent years, nasal nitric oxide has been of growing interest to investigators and clinicians. The most persuasive data for nasal nitric oxide as a clinical tool consist of chronic rhinosinusitis.

Nasal nitric oxide is a useful and promising biomarker of ostiomeatal complex patency. The varying estimation techniques and technology continue to hinder standardized interpretation and execution of nasal nitric oxide as a biomarker for sinonasal diseases, concluded the study authors.