scholarly journals Observational study investigating Ectoin® Rhinitis Nasal Spray as natural treatment option of acute rhinosinusitis compared to treatment with Xylometazoline

2021 ◽  
Author(s):  
Nina Werkhäuser ◽  
Andreas Bilstein ◽  
Kathrin Mahlstedt ◽  
Uwe Sonnemann
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Treatment Option ◽  
Symptomatic Relief ◽  
Concomitant Treatment ◽  
Acute Rhinosinusitis ◽  
Nasal Decongestants ◽  
Natural Treatment

Abstract Introduction Symptomatic relief of acute rhinosinusitis is commonly achieved with nasal decongestants. The current observational study investigated the efficacy and safety of treatment of acute rhinosinusitis with Ectoin® Rhinitis Spray compared to or in combination with Xylometazoline-containing decongesting nasal spray. Methods Patients with acute rhinosinusitis applied either Ectoin® Rhinitis Spray, Xylometazoline nasal spray or a combination of both products. Rhinosinusitis symptoms were assessed, and nasal oedema and endonasal redness were determined by rhinoscopy. Patient diaries based on the validated SNOT (Sino Nasal Outcome Test) questionnaire evaluated rhinosinusitis parameters over time and influences of the disease on quality of life. Following treatment, investigators and patients judged the efficacy and tolerability. Results Ectoin® Rhinitis Spray diminished common rhinosinusitis symptoms such as nasal obstruction, nasal secretion, facial pain/headache, and smell/taste impairment. Upon treatment over 7 days, rhinosinusitis sum scores decreased statistically significantly (p < 0.001) by − 64.25%, which was comparable to that achieved with Xylometazoline-containing decongesting nasal spray (− 67.60%). No side effects were observed during treatment with Ectoin® Rhinitis Spray, whereas treatment with Xylometazoline-containing nasal spray resulted in nasal mucosa dryness. Concomitant treatment with both products diminished the development of nasal dryness and required fewer applications of Xylometazoline-containing nasal spray. Conclusion Ectoin® Rhinitis Spray is an effective, natural treatment option for acute rhinosinusitis, which may be used as monotherapy or as add-on treatment with a Xylometazoline-containing nasal spray. The concomitant use of Ectoin® Rhinitis Spray might reduce the needed dose of decongestant nasal spray and counteract bothersome side effects such as dry nasal mucosa. Trial registration The current study was registered in the ClinicalTrials.gov database under the identifier: NCT03693976 (date of registration: Oct 3, 2018).

Safety of the use of xylometazoline nasal spray in young children undergoing lacrimal surgery: an observational study

2017 ◽  
Vol 28 (3) ◽  
pp. 279-281
Author(s):  
Varajini Joganathan ◽  
Bijan Beigi
Keyword(s):  
Side Effects ◽  
Young Children ◽  
Observational Study ◽  
General Anesthesia ◽  
Retrospective Analysis ◽  
Nasal Spray ◽  
Lacrimal Surgery ◽  
Cardiovascular Side Effects ◽  
Nasal Decongestants ◽  
Recovery From Anesthesia

Purpose: It is common practice to prepare the nasal mucosa with decongestant in children undergoing lacrimal surgery. Xylometazoline 0.05% (Otrivine) nasal spray is commonly used. It has been reported to cause cardiovascular side effects. In the absence of formal guidelines on the safety of the use of nasal decongestants in children, we reviewed our practice to answer the question: How safe is preoperative use of xylometazoline in children undergoing lacrimal surgery? To our knowledge, this is the first study to address the potential side effects of the use of xylometazoline preoperatively in children undergoing lacrimal surgery. Methods: This was a retrospective analysis of medical notes of children undergoing lacrimal surgery with the use of preoperative intranasal xylometazoline 0.05% over a 5-year period. Results: Twenty-nine children, age 1-6 years (mean 3 years), underwent lacrimal surgery under general anesthesia with preoperative use of intranasal xylometazoline. Topical intranasal 1:10,000 adrenaline was used during surgery in all patients. All children were found to have uneventful surgery and recovery from anesthesia. Conclusions: Xylometazoline 0.05% intranasal use for prelacrimal surgery was found to be effective and safe. Addition of sympathomimetic topical adrenaline (1:10,000) did not impose any risks. The type of general anesthesia may influence the cardiovascular side effects anecdotally recorded during xylometazoline use.

scholarly journals Evaluating the Protective Properties of a Xyloglucan-Based Nasal Spray in a Mouse Model of Allergic Rhinitis

2021 ◽  
Vol 22 (19) ◽  
pp. 10472
Author(s):  
Marika Lanza ◽  
Giovanna Casili ◽  
Alessia Filippone ◽  
Michela Campolo ◽  
Irene Paterniti ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Nasal Spray ◽  
Standard Of Care ◽  
Similar Efficacy ◽  
Specific Ige ◽  
Ar Model ◽  
Concomitant Treatment ◽  
Junction Protein ◽  
Significant Efficacy

A breached nasal epithelial barrier plays an important role in driving allergic rhinitis (AR). Corticosteroids remain the standard of care (SoC) but come with side effects, thus alternative safe and effective treatments able to avoid inflammation and restore barrier integrity are needed. The aim of the present study is to evaluate the barrier-forming capacity of a xyloglucan-based nasal spray (XG) and compare its efficacy to several SoC treatments (corticosteroid spray, oral mast-cell stabilizer and oral antihistamine) in reducing allergic responses in addition to its effect when concomitantly administered with an antihistamine. An ovalbumin (OVA)-induced mouse AR model was used. XG shows a significant efficacy in reducing histological damage in AR mice; improves nasal rubbing and histamine-induced hyper-responsiveness. Total and OVA-specific IgE as well as pro-inflammatory cytokines are significantly reduced compared to OVA challenged-mice, with im-proved efficacy when used as an add-on treatment. However, XG reduces mucous secreting cells (PAS-positive) and mucin mRNA expression similar to the corticosteroid-treated mice. XG-spray maintains tight junction protein expression (ZO-1) and conversely decreases HDAC1 significantly; the latter being highly expressed in AR patients. Moreover, the concomitant treatment showed in all of the endpoints a similar efficacy to the corticosteroids. This innovative approach may represent a novel therapeutic strategy for nasal respiratory diseases like AR, reducing undesirable side effects and improving the quality of life in patients.

scholarly journals Efficacy of Mometasone Nasal Spray in Children with Snoring due to Adenoids

2014 ◽  
Vol 7 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Vipan Gupta ◽  
Sunder Singh ◽  
Prithpal S Matreja
Keyword(s):  
Observational Study ◽  
Nasal Obstruction ◽  
Nasal Spray ◽  
Pediatric Population ◽  
Symptomatic Relief ◽  
Alternative Therapy ◽  
Adenoid Hypertrophy ◽  
Intranasal Steroids ◽  
Before And After

ABSTRACT Background Snoring and OSA is very commonly seen among the pediatric population, most commonly due to adenoid and tonsil hypertrophy which requires adenotonsillectomy. The effect of this surgery on the immunity is controversial. This study was planned to see any alternative therapy which can delay or avoid the surgery by providing symptomatic relief to the patient. Objective To see the effect of intranasal mometasone on nasal obstruction due to adenoids, hence relieving the OSA and snoring. Design Prospective and observational study. Materials and methods Fifty-five children having snoring and or OSA due to adenoids were given intranasal mometasone. The symptoms before and after treatment were compared using OSA 18 questionnaire. Results There was significant improvement in all the domains of OSA 18. The average total score showed improvement from 56.33 to 51.51 which is significant (p < 0.001). Conclusion The use of intranasal steroids is easy and effective method to improve nasal obstruction, snoring and OSA among children having adenoid hypertrophy. How to cite this article Gupta V, Gupta M, Matreja PS, Singh S. Efficacy of Mometasone Nasal Spray in Children with Snoring due to Adenoids. Clin Rhinol An Int J 2014;7(1):1-4.

Intranasal Corticosteroid Injection: Indications, Technique, and Complications

1979 ◽  
Vol 87 (2) ◽  
pp. 207-211 ◽  
Author(s):  
Richard L. Mabry
Keyword(s):  
Side Effects ◽  
Nasal Obstruction ◽  
Nasal Mucosa ◽  
Corticosteroid Injection ◽  
Symptomatic Relief ◽  
Intranasal Corticosteroid ◽  
Submucosal Injection

The intranasal injection of corticosteroids for symptomatic relief of nasal obstruction in selected cases has been described by several authors1–8 and widely used for over 25 years. Recently, circulated reports of blindness following such injections caused a number of otolaryngologists to discontinue using the procedure. All reported cases of visual complications following intranasal corticosteroid injection are reviewed, 9,12,13,17 together with the reported experiences of the author20 and others15–17 who have successfully used the technique in thousands of cases. Preliminary topical cocainization of nasal mucosa and slow submucosal injection of a micronized corticosteroid suspension to minimize the risk of vasospasm and embolization involving the ophthalmic circulation are stressed. Indications for the procedure, the most common side effects, and the proper technique of injection are described.

scholarly journals The Effectiveness of the Bacteria Derived Extremolyte Ectoine for the Treatment of Allergic Rhinitis

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Andreas Bilstein ◽  
Nina Werkhäuser ◽  
Anna Rybachuk ◽  
Ralph Mösges
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Nasal Spray ◽  
Inflammatory Diseases ◽  
Symptom Relief ◽  
Concomitant Treatment ◽  
Good Tolerability ◽  
Study Results ◽  
Patient Groups ◽  
Preclinical And Clinical Studies

Nonpharmacological therapies with a good tolerability and safety profile are of interest to many patients with allergic rhinitis, as a relevant proportion of them have reservations about guideline-concordant pharmacological therapies due to their local irritations and side effects. Ectoine is a bacterial-derived extremolyte with an ability to protect proteins and biological membranes against damage caused by extreme conditions of salinity, drought, irradiation, pH, and temperature. Evidence from preclinical and clinical studies attests its effectiveness in the treatment of several inflammatory diseases, including allergic rhinitis. In this review, we analyzed 14 recent clinical trials investigating ectoine nasal spray in patients with allergic rhinitis and/or conjunctivitis, including sensitive patient groups like children or pregnant women. Some studies investigated monotherapy with ectoine; others investigated combination therapy of ectoine and an antihistamine or a corticosteroid. Analysis of the study results demonstrated that patients with mild-to-moderate symptoms of allergic rhinitis can be successfully treated with ectoine-containing nasal spray. When applied as monotherapy, ectoine exerted noninferior effects compared to first-line therapies such as antihistamines and cromoglicic acid. Using ectoine as an add-on therapy to antihistamines or intranasal glucocorticosteroids accelerated symptom relief by days and improved the level of symptom relief. Importantly, concomitant treatment with ectoine was proven beneficial in a group of difficult-to-treat patients suffering from moderate-to-severe rhinitis symptoms. Taken together, the natural substance ectoine represents a viable alternative for allergic rhinitis and conjunctivitis patients who wish to avoid local reactions and side effects associated with pharmacological therapies.

Phototherapy is a pathogenetic method in the treatment of acute sinusitis

2020 ◽  
pp. 34-39
Author(s):  
Arsen Korkmazov
Keyword(s):  
Nasal Mucosa ◽  
Local Effect ◽  
Nasal Secretion ◽  
Visible Range ◽  
Neutrophil Granulocytes ◽  
Physical Treatment ◽  
Local Immunity ◽  
Acute Rhinosinusitis ◽  
Therapeutic Measures ◽  
Effect Of Light

Currently, physical treatment methods, in particular use of photochromotherapy in the treatment of sinusitis, are of interest. Is to investigate the local effect of light in the visible range (450 nm) on the factors of local infection protection of the nasal mucosa. The study involved 50 patients with a diagnosis of acute rhinosinusitis at the age of 27.23±3.29 years. Exposure of the mucous membrane of the nasal cavity was carried out in accordance with the parameters: 450 nm wavelength (monochromatic non-polarized blue light), during 5 minutes for each nostril. Sessions of photochromotherapy were carried out according to the "Sanitary norms and rules for the design and operation of lasers" No. 5804-91. Inclusion of photochromotherapy in the complex of therapeutic measures for patients with acute rhinosinusitis helps to reduce the total number of neutrophils in nasal secretion, normalize their lysosomal activity, NBT-reducing activity, activity and intensity of phagocytosis. Restoration of local immunity factors in nasal mucosa, expressed in normalizing the functional and metabolic status of neutrophil granulocytes of the nasal secretion, can serve as one of the criteria for the effectiveness of treatment using photochromotherapy

scholarly journals Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

2021 ◽  
Vol 13 ◽  
pp. 117957352110160
Author(s):  
Thomas Mathew ◽  
Kurian Thomas ◽  
Saji K John ◽  
Shruthi Venkatesh ◽  
Raghunandan Nadig ◽  
...  
Keyword(s):  
Observational Study ◽  
Myasthenia Gravis ◽  
Treatment Option ◽  
Early Treatment ◽  
Early Stage ◽  
Tertiary Care ◽  
Response To Treatment ◽  
Myasthenic Crisis ◽  
Achr Antibody ◽  
Significant Difference

Background: Rituximab is reserved for treating refractory myasthenia gravis (MG) patients. Here we report our experience with rituximab in AChR antibody positive generalized MG (gMG) and impending myasthenic crisis (IMC). Methods: This retrospective, observational study, conducted at a tertiary care, neuroimmunology clinic, analyzed the data of patients with AChR antibody positive gMG, treated with rituximab between 1st January 2016 and 30th October 2018. Results: Eleven patients with AChR antibody positive gMG received rituximab. Mean age of the cohort was 50.54 ± 18.71 years with 9 males. Seven out of 11 patients received rituximab in the early stage (<2 years from onset) and had good response to treatment. Four of the 5 patients with IMC improved with rituximab alone. In the 10 patients who regularly followed up, there was a significant difference between the QMG scores at baseline and at 1, 2, 6, 12, and 18 months ( P < .0001). Conclusion: Rituximab appears to be a potentially effective early treatment option for AChR antibody positive generalized MG and impending myasthenic crisis.

An Instant, Safe, Antihistamine, Anti-Inflammatory and Decongestant Polymeric Nasal Barrier to Prevent and To Treat Allergic Rhinitis in Children

2021 ◽  
Vol 7 (5) ◽  
pp. 01-09
Author(s):  
Ravi Shrivastava
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Side Effects ◽  
Symptom Score ◽  
Inflammatory Cytokines ◽  
Nasal Mucosa ◽  
Eosinophil Count ◽  
Allergen Exposure ◽  
Glycerol Solution

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-α, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

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