[Evidence-based phytotherapy in otorhinolaryngology-the update]

For centuries, phytopharmaceuticals were the primary form of medicine used worldwide to treat, alleviate, or prevent disease. Phytotherapy harnesses the therapeutic effects of plants and their components (phytopharmaceuticals). According to the World Health Organization (WHO), phytotherapy remains a crucial pillar of healthcare today and is expected to become even more important in the future. Referring to our initial review article from 2011, we now present an update to cover the period from 2011 to the present.

Which phytopharmaceuticals are relevant in otorhinolaryngology, and is there evidence-based data supporting their use?

A literature search was conducted for the period from 2011 to 2024 using PubMed (MEDLINE). The search results were further refined by focusing on randomized, clinical, and controlled trials written in English and adhering to Good Clinical Practice (GCP) guidelines.

The search term "phytotherapy" yielded 44,202 results. After limiting to 2011-2024 and applying the aforementioned criteria, 1685 results remained. With respect to otorhinolaryngology, only six studies remained. This procedure was applied to all search terms and otorhinolaryngology-specific search terms. Exclusion criteria included homeopathy, shamanistic medicine, case reports, studies not conducted according to GCP guidelines, and studies not written in English. The search term "traditional medicine" returned 275,079 results. After limiting to 2011-2024 and applying the aforementioned criteria, 6448 results remained. With respect to otorhinolaryngology, only two studies remained. The search term "Chinese medicine" returned 378,231 results. After limiting to 2011-2024 and applying the criteria, 7815 results remained. With respect to otorhinolaryngology, only one study remained. In total, 14 studies were selected and presented.

Since 2011, a substantial number of new studies on phytotherapy have been published. However, few studies utilize standardized measurement methods and materials, thus precluding objective statements. Such standardization is essential for practical therapeutic application. Due to the frequently inadequate adherence to GCP guidelines, there has been no significant gain in knowledge regarding the effects and efficacy of phytopharmaceuticals. Intensive clinical research is still required to adequately utilize phytotherapy.