scholarly journals The role of bacteriotherapy in the restoration of the nasal mucosa in patients with chronic rhinosinusitis

2021 ◽  
pp. 62-67
Author(s):  
Alexander N. Naumenko ◽  
Ahmad Abdelrazzaq Moh’dabdel razzaq ◽  
Margaryta R. Amirkhanova
Keyword(s):  
Topical Corticosteroid ◽  
Chronic Rhinosinusitis ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Mometasone Furoate ◽  
Streptococcus Salivarius ◽  
Saline Irrigation ◽  
Significant Difference ◽  
Snot 22

Topicality: Chronic rhinosinusitis is an polyetiological disease with shch basic complaints as nasal obstruction, nasal discharge, headache or facial pain and reduction of smell. The SNOT-22 questionnaire is widely used to detail patient complaints in various fields. Chronic rhinosinusitis is most often divided into chronic rhinosinusitis with polyps and without nasal polyps. Given the large number of phenotypes and endotypes of the disease, it is important to study further the mechanisms of pathogenesis and selec- tion of individualized treatment. Aim: to determine the role of topical application of Streptococcus salivarius 24SMBc and Streptococcus orals 89a in the form of nasal spray in improving the condition of the nasal mucosa in chronic rhinosinusitis and reducing the recurrence rate. Materials and methods: The study was conducted at the Department of Otolaryngology of National Medical University on the basis of KNP "Oleksandrivs’ka Clinical Hospital of Kyiv". It was attended by 82 patients (38 women and 44 men) aged 18 to 60 years, who were randomly divided into two groups. The 1st group (main, 43 patients) received treatment: irrigation therapy with isotonic saline, topical corticosteroid mometasone furoate in combination with a nasal spray, which contains autochthonous saprophytes (AC) – Streptococcus salivarius 89SMBc and Streptococcus orals 89a nasal mucus. The 2nd group (control, 39 patients) received nasal saline irrigation therapy, topical corticosteroid mometasone furoate in combination with topical antibiotic framicetin sulfate. Assessment was performed according to the VAS scale, SNOT-22 questionnaire (before treatment, on the 10th day of treatment and one month after the end of therapy) and determining the frequency of relapses in patients of both groups. Results: According to the obtained results, the indicators of patients of both groups before treatment and on the 10th day had no statistically significant difference (p>0.05). However a month later patients in the main group had better results (p<0.05) on the scale of VAS and the SNOT-22 questionnaire. So, topical use of Streptococcus salivarius 24SMBc and Streptococcus orals 89a as a nasal spray is effective and can be recommended for the treatment of patients with chronic rhinosinusitis in the acute stage.

Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps

2011 ◽  
Vol 6 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Erkan Vuralkan ◽  
Cem Saka ◽  
Istemihan Akin ◽  
Sema Hucumenoglu ◽  
Binnur Uzmez Unal ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Nasal Spray ◽  
Peripheral Blood ◽  
Nasal Polyposis ◽  
Mometasone Furoate ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Snot 22

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.

Daily versus self-adjusted dosing of topical mometasone furoate nasal spray in patients with allergic rhinitis: randomised, controlled trial

2009 ◽  
Vol 124 (4) ◽  
pp. 397-401 ◽  
Author(s):  
M A Khan ◽  
A S Abou-Halawa ◽  
A A Al-Robaee ◽  
A A Alzolibani ◽  
H A Al-Shobaili
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Cavity ◽  
Nasal Spray ◽  
Controlled Trial ◽  
Symptom Control ◽  
Mometasone Furoate ◽  
The Self ◽  
Cavity Volume ◽  
Significant Difference ◽  
Randomised Controlled

AbstractBackground:Many patients with allergic rhinitis are reluctant to use daily intranasal steroids for prolonged periods. A self-adjusted regimen which delivers reasonable control of allergic rhinitis may be more acceptable to such patients.Objectives:To compare the efficacy of daily use of mometasone furoate nasal spray, versus a self-adjusted regimen, in patients with chronic allergic rhinitis, in terms of symptom control and nasal volume change.Setting:Ambulatory visits in an office setting.Patients and methods:Sixty patients with chronic allergic rhinitis were randomised: 30 were prescribed mometasone furoate nasal spray once daily for six weeks, while 30 were prescribed the same spray daily for one week, every alternate day for one week and then on a self-adjusted regimen for four weeks. Patients kept a symptom diary documenting sneezing, rhinorrhoea, nasal blockage and nasal itching. Acoustic rhinometry was used to measure the total nasal cavity volume at the first visit and at the end of the treatment period.Results:The total nasal score on treatment days showed an improvement in both groups, compared with baseline measurements. There was no significant difference in total nasal scores between the two groups, except on days 10 (p = 0.043), 20 (p = 0.008), 23 (p = 0.19), 30 (p = 0.008) and 37 (p = 0.000), when the daily group's total nasal score was significantly lower than the self-adjusted group's total nasal score, and on day 8 (p = 0.004), when the self-adjusted group's total nasal score was significantly lower than the daily group's total nasal score. Total nasal cavity volume significantly increased in both groups (p = 0.0001), with no statistically significant difference between the groups.Conclusions:Self-adjusted dosage of mometasone furoate nasal spray gives reasonable control of allergic rhinitis (albeit with some ‘breakthrough’ symptoms). Patients should learn how to control these symptoms with the least number of steroid doses.

Assessment by Nasal Biopsy of Long-Term Use of Mometasone Furoate Aqueous Nasal Spray (Nasonex) in the Treatment of Perennial Rhinitis

1998 ◽  
Vol 118 (5) ◽  
pp. 648-654 ◽  
Author(s):  
E. Minshall ◽  
O. Ghaffar ◽  
L. Cameron ◽  
F. O'Brien ◽  
H. Quinn ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Spray ◽  
Nasal Mucosa ◽  
Squamous Metaplasia ◽  
Mometasone Furoate ◽  
Biopsy Specimens ◽  
Tissue Changes ◽  
Perennial Rhinitis ◽  
Nasal Biopsy

Allergic rhinitis is associated with specific histopathologic changes in the nasal mucosa including squamous metaplasia and local eosinophilia. Previous studies have shown that mometasone furoate aqueous nasal spray is effective and well tolerated in reducing perennial rhinitis and seasonal allergic rhinitis symptoms. We undertook a multicenter, open-label study to evaluate, by nasal biopsy, the tissue changes associated with mometasone furoate use (200 μg/day) during a 12-month treatment period in patients with perennial rhinitis. Of the 69 patients enrolled in the study, 52 completed all 12 months of treatment. Nasal biopsy specimens obtained from patients at baseline and after treatment were evaluated in a blinded fashion by computerized image analysis, qualitative histologic examination, and immunocytochemistry. Morphologic examination of nasal biopsy specimens showed a decrease in focal metaplasia, no change in epithelial thickness, and no sign of atrophy after treatment with mometasone furoate. Immunocytochemical analyses of nasal biopsy specimens obtained before and after treatment revealed a significant decrease in major basic protein-positive eosinophils and tryptase-positive mast cells in the epithelium and lamina propria after treatment. Mometasone furoate appeared to attenuate the inflammatory process by reducing the extent of inflammatory cell infiltration, particularly of eosinophils. This study demonstrated that long-term administration of mometasone furoate is not associated with adverse tissue changes in the nasal mucosa of patients with perennial rhinitis. (Otolaryngol Head Neck Surg 1998;118:648–54.)

scholarly journals A Study on the Efficacy of Saline Nasal Irrigation in Chronic Rhinosinusitis

2021 ◽  
Vol 10 (30) ◽  
pp. 2266-2270
Author(s):  
Rachana Ramachandran ◽  
Santhi Thankappan Pillai
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Post Treatment ◽  
Oral Drug ◽  
P Value ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Significant Difference ◽  
Chronic Rhino Sinusitis

BACKGROUND The objective of this study was to test as to whether daily saline nasal irrigation improved sinus symptoms in adult subjects with chronic rhino sinusitis, and also study the safety of saline irrigation, incidence of any complication and improvement in quality of life in these patients. METHODS This was a prospective observational study conducted between two groups of patients at Government TD Medical College, Alappuzha. Patients who satisfied the criteria for diagnosing chronic rhino sinusitis were included in the study. The first group was given saline nasal irrigation with oral drug therapy while the second group was put on oral drugs alone. Each subject was given a pretested, structured questionnaire. Along with socio-demographic information, the questionnaire also contained queries of quality of life measure, compliance of nasal irrigation and adverse effects following its use. RESULTS The pre-treatment scores and post treatment scores were analysed and the results were statistically significant with P values of < 0.001 in all. 77 % of the patients in the saline irrigation group were strictly using saline nasal irrigation which meant a satisfactory compliance and the improvement in post treatment scores was statistically highly significant with a P value of < 0.001. Also there was a statistically significant difference between the mean pre-test and post test scores of the two groups with P value of < 0.001 and t value of 51.942 using the paired t test. CONCLUSIONS Chronic rhinosinusitis has a major negative impact on the healthcare and economy of not only the patients but also of the society. Saline nasal irrigation is an effective yet easy method of therapy in alleviating the symptoms of chronic rhinosinusitis and improving the quality of life in these chronic sufferers. KEY WORDS Chronic Rhinosinusitis, Saline Nasal Irrigation, Quality of Life, Economic Burden

Efficacy of Dexamethasone Versus Fluticasone Nasal Sprays in Postoperative Patients With Chronic Rhinosinusitis With Nasal Polyps

2019 ◽  
Vol 33 (5) ◽  
pp. 478-482 ◽  
Author(s):  
Kristin A. Seiberling ◽  
Stephanie C. Kidd ◽  
Grace H. Kim ◽  
Christopher A. Church
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Standard Dose ◽  
Controlled Trial ◽  
Sinus Surgery ◽  
Double Blind ◽  
Nasal Sprays ◽  
Significant Difference ◽  
Nasal Steroid ◽  
Snot 22

Background Topical nasal steroids are commonly prescribed to patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) following endoscopic sinus surgery (ESS). They are found to be effective in improving symptoms and quality of life as well as reducing the incidence of nasal polyps recurrence. Objective We sought to determine whether a higher concentration of topical nasal steroid spray is more effective than the standard nasal steroid spray in controlling symptoms and preventing recurrence of polyps in patients with CRSwNP who underwent ESS. Method A double-blind randomized controlled trial was performed on patients with CRSwNP after ESS. Patients were randomized into 2 treatment groups: one received topical nasal dexamethasone 0.032% and the other, fluticasone proprionate. The 22-item Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy nasal endoscopy scores were measured at the initiation of topical nasal steroid treatment and then at approximately 4-, 8-, and 12-week intervals. Results Thirty-nine patients were enrolled in the study. Eighteen patients continued using the medications prescribed to them for the duration of the study. There were 8 patients in the dexamethasone group and 10 patients in the fluticasone group. Both groups saw significant improvements in postoperative SNOT-22 and Lund-Kenney scores over time. There was no significant difference in improvement between the groups. Conclusion There is no significant increased benefit in using a higher dose nasal steroid spray compared to the standard dose nasal steroid spray after ESS.

scholarly journals Liposomal Nasal Spray versus Guideline-Recommended Steroid Nasal Spray in Patients with Chronic Rhinosinusitis: A Comparison of Tolerability and Quality of Life

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Eitenmüller ◽  
Lisa Piano ◽  
Myriam Böhm ◽  
Kija Shah-Hosseini ◽  
Andreas Glowania ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Symptom Score ◽  
Nasal Spray ◽  
Symptom Reduction ◽  
Evaluation Questionnaire ◽  
Recommended Treatment ◽  
Significant Difference ◽  
Noninterventional Study

Objective. To investigate the tolerability and impact on quality of life of liposomal nasal spray compared to guideline-recommended steroid-based therapy in patients with chronic rhinosinusitis. Symptom reduction and use of antisymptomatic medication were also examined. Methods. In this monocenter, prospective, controlled, open, and noninterventional study, 60 patients with chronic rhinosinusitis were treated with liposomal nasal spray and 30 patients received steroid-based therapy. The study comprised five visits occurring at intervals of two to four weeks. Efficacy was determined according to the sinusitis symptom score documented daily. The polyp score was recorded at the initial and final visits. Tolerability was determined through the Nasal Spray Evaluation Questionnaire, and quality of life was ascertained with the SNOT-20 Score. Results. Both treatments achieved a significant reduction of sinusitis symptoms (P<0.05) and also rhinoscopic improvement (P<0.05). The majority of patients assessed the treatments as “good” or “very good,” and the quality of life improved significantly (P<0.05). There was no significant difference in symptom reduction, QoL, and endoscopic exams between both treatments. Conclusion. The treatment of chronic rhinosinusitis with liposomal nasal spray results in a similar, significant reduction of symptoms and significant improvement in quality of life as guideline-recommended treatment and is therefore a comparable alternative.

Outcomes in Treatment of Rhinosinusitis in the Setting of Medication Induced Immunosuppression

2020 ◽  
pp. 194589242094793
Author(s):  
Rahul Alapati ◽  
Jayakar V. Nayak ◽  
Peter H. Hwang ◽  
Zara M. Patel
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Management ◽  
Medical Management ◽  
Care Center ◽  
Tertiary Care ◽  
Treatment Pathways ◽  
Acute Rhinosinusitis ◽  
Significant Difference ◽  
Immunosuppressed Patients ◽  
Snot 22

Background There is no data currently available to direct nuanced treatment for recurrent acute and chronic rhinosinusitis (RARS, CRS) in patients on daily, long term medications that suppress the immune system. Objective This study sought to evaluate the outcomes of different treatment pathways when treating immunosuppressed patients with chronic rhinosinusitis or recurrent acute rhinosinusitis. Methods A retrospective review of patients on immune suppressing medication presenting to a tertiary care center with RARS or CRS between the years 2014–2019 was completed. Patients were categorized into three groups based on treatment: medical management alone (MM), surgery after medical management (SAMM), or upfront surgery (US). Lund-Kennedy scores (LKS) and SNOT-22 scores were evaluated at baseline, 1 month, 3 months and 6 months from presentation. Results 68 patients met inclusion criteria, with no difference in demographics between groups. Patients who were treated with US and SAMM had significantly higher baseline LKS than those who were treated with MM alone (p = 0.050, p = 0.039). Once this difference was controlled for, there was no significant difference in overall change of LKS between the three groups over time. There was no significant disparity in baseline SNOT-22 scores between the three groups, but patients who underwent US had a significantly higher improvement in SNOT-22 from baseline compared to those undergoing MM alone (p = 0.013). Conclusion Patients experiencing chronic rhinosinusitis and recurrent acute rhinosinusitis who are taking immunosuppressive medication can significantly improve from both medical and surgical management, but upfront surgical management appears to result in greater disease resolution relative to medical management in those with CRS. More study is needed in the RARS patient population regarding upfront surgery versus medical management.

Balloon Catheter Dilation in Pediatric Chronic Rhinosinusitis: A Meta-analysis

2020 ◽  
Vol 34 (5) ◽  
pp. 694-702 ◽  
Author(s):  
Vijay A. Patel ◽  
Daniel C. O’Brien ◽  
Jad Ramadan ◽  
Michele M. Carr
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Standard Treatment ◽  
Meta Analysis ◽  
Balloon Catheter ◽  
Balloon Dilation ◽  
Saline Irrigation ◽  
Treatment Regimens ◽  
Significant Difference

Background Paranasal sinus balloon catheter dilation (BCD) represents a tool that has been shown to be safe in the management of pediatric chronic rhinosinusitis (pCRS); however, its efficacy compared to standard treatment regimens has not been well established. Objective The purpose of this meta-analysis was to evaluate the clinical utility of BCD in pCRS. Methods Articles reporting BCD for pCRS in patients under 18 years of age were identified via the following search terms: sinusitis OR rhinosinusitis AND balloon dilatation OR balloon dilation OR balloon sinuplasty OR sinuplasty AND adolescent OR children OR infant OR pediatric OR toddler. The primary outcome analyzed includes quality of life improvement as measured via Sinus and Nasal Quality of Life Survey (SN-5) or Sino-nasal Outcome Test (SNOT-22) scores. Results Eighty studies were abstracted; 10 studies were included for final qualitative analysis after dual investigator screening. Three studies described BCD with surgical controls, including adenoidectomy, saline irrigation, or maxillary antrostomy. Noninferiority was not demonstrated (ie, BCD is inferior) in 2 of 3 studies. Pooled analysis utilizing a random effects model revealed a decreased effect size yet no statistically significant difference between BCD and standard operative techniques as measured by quality of life measures ( g = −0.04, I2 = 41%). Conclusion This work highlights a lack of published evidence regarding the role of BCD in pCRS. Two of the 3 included studies demonstrated the inferiority of BCD when compared to other standard surgical interventions, whereas meta-analysis was unable to detect any statistically significant difference between standard treatment regimens. Future scientific investigations are necessary to assess the comparative effectiveness of BCD in pCRS.

scholarly journals Impact of Pharmacotherapy to decrease Interleukin-6 in patients with chronic rhinosinusitis without nasal polyp

2020 ◽  
Vol 50 (1) ◽  
pp. 30
Author(s):  
Lina Marlina ◽  
Sinta Sari Ratunanda ◽  
Teti Madiadipoera
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Visual Analog Scale ◽  
Interleukin 6 ◽  
Analog Scale ◽  
Prick Test ◽  
Significant Difference ◽  
Sinonasal Outcome Test ◽  
Snot 22

Background: Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinuses mucosa, ongoing for more than 12 weeks. Even now it still creates socioeconomic problem in both developed and developing countries. Pharmacotherapy administration is essential for decreasing the severity of symptom, improving quality of life, and decreasing interleukin (IL)-6 level. Objective: To find out the effect of pharmacotherapy on severity of the symptom, quality of life, and IL-6 level. Method: Randomized clinical trial with pre and posttest design, on 20 CRS without polyp patients, divided into two groups based on skin prick test results. Both groups were equally treated with nasal irrigation, nasal corticosteroid, and antibiotic amoxicillin clavulanate for 14 days. All subjects were assessed for Visual Analog Scale (VAS) score, nasoendoscopy (NE) score, Sinonasal Outcome test (SNOT)-22, and IL-6 level. Statistical analysis was performed with Mann Whitney and Wilcoxon methods. Result: There were significant differences in total analysis results on VAS scores, NE scores, SNOT-22, and IL-6 levels in both groups, with values p<0.05. There was improvement in all variables after pharmacotherapy, but there was no significant difference between the case and control groups, with values p>0.05. Conclusion: Pharmacotherapy in both groups resulte’ in reduced severity of symptoms, improved quality of lives, and decreased IL-6 levels.Keywords: Interleukin-6, pharmacotherapy, chronic rhinosinusitis without polyp, quality of life ABSTRAK Latar belakang: Rinosinusitis kronik (RSK) merupakan inflamasi pada mukosa hidung dan sinus paranasal, yang berlangsung selama lebih dari 12 minggu. Hingga saat ini masih memengaruhi sosioekonomi di negara maju maupun negara berkembang. Pemberian farmakoterapi sangat penting untuk memperbaiki derajat gejala, meningkatkan kualitas hidup, dan menurunkan kadar interleukin (IL)-6. Tujuan: Mengetahui pengaruh pemberian farmakoterapi terhadap perbaikan derajat gejala, peningkatan kualitas hidup, dan penurunan kadar IL-6. Metode: Penelitian kuasi eksperimental, label terbuka pra dan pascaterapi, pada 20 penderita RSK tanpa polip, dibagi dua kelompok berdasarkan hasil uji tusuk kulit. Perlakuan pada kedua kelompok sama, diberikan irigasi hidung, kortikosteroid intranasal, dan antibiotik amoksisilin klavulanat selama 14 hari. Penelitian dilakukan dengan menilai skor Visual Analog Scale (VAS) gejala hidung, skor nasoendoskopi (NE), Sinonasal Outcome test (SNOT)-22, dan kadar IL-6. Analisis statistik menggunakan metode Mann Whitney dan Wilcoxon. Hasil: Didapati perbedaan bermakna pada hasil analisis total pada skor VAS gejala hidung, skor NE, SNOT-22, dan kadar IL-6 pada kedua kelompok dengan nilai p<0,05. Didapati perbaikan pada semua variabel setelah 14 hari pemberian medikamentosa maksimal, namun tidak terdapat perbedaan bermakna antara kedua kelompok dengan nilai p>0,05. Kesimpulan: Pemberian farmakoterapi pada kedua kelompok memberikan hasil berupa perbaikan derajat gejala, peningkatan kualitas hidup, dan penurunan kadar IL-6.

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