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This study investigates whether simultaneous exposure to these compounds elicits synergistic cytotoxicity in sinonasal epithelial cells (SNECs). Ethmoid sinus mucosal specimens were procured from eight patients during endoscopic sinus surgery. SNECs were expanded on culture plates and exposed to various concentrations of DEET and permethrin (0\u20105\u2009mM), individually and concurrently, for up to 156\u2009hours. Experiments were replicated in triplets, and cell viability was recorded every 2\u2009hours using <jats:italic>Incucyte<\/jats:italic> real\u2010time cell imaging system. Synergy score was calculated on the basis of the Loewe additivity synergy model. DEET and permethrin exhibited synergistic cytotoxicity across all eight tissues, albeit with variations in onset and magnitude. In conclusion, the concurrent exposure of DEET and permethrin can lead to synergistic cytotoxicity in sinonasal epithelia.<\/jats:p>","DOI":"10.1002\/oto2.70145","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T01:49:51Z","timestamp":1751939391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Synergistic Cytotoxicity of Permethrin and <i>N<\/i>,<i>N<\/i>\u2010Diethyl\u2010Meta\u2010Toluamide on Sinonasal Epithelial Cells"],"prefix":"10.1002","volume":"9","author":[{"given":"Jivianne T.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery David Geffen School of Medicine at University of California, Los Angeles Los Angeles California USA"},{"name":"Department of Surgery Greater Los Angeles Veterans Administration Healthcare System, Los Angeles Los Angeles California 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