Topical Therapies for Refractory Chronic Rhinosinusitis

Akshay Sanan; Mindy Rabinowitz; Marc Rosen; Gurston Nyquist

doi:10.1016/j.otc.2016.08.011

Topical Therapies for Refractory Chronic Rhinosinusitis

Otolaryngol Clin North Am. 2017 Feb;50(1):129-141. doi: 10.1016/j.otc.2016.08.011.

Authors

Akshay Sanan¹, Mindy Rabinowitz¹, Marc Rosen¹, Gurston Nyquist²

Affiliations

¹ Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
² Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address: Gurston.Nyquist@Jefferson.edu.

PMID: 27888909
DOI: 10.1016/j.otc.2016.08.011

Abstract

Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS. Stents are a new modality with preliminary data showing they are an option when traditional treatment has failed. Further research with long-term effects and outcomes studies for refractory CRS are needed.

Keywords: Anti-inflammatory; Antimicrobial; Chronic rhinosinusitis; Stents; Surfactant; Topical therapy.

Publication types

Review

MeSH terms

Administration, Topical*
Chronic Disease
Humans
Medication Therapy Management*
Nasal Mucosa / drug effects*
Rhinitis* / drug therapy
Rhinitis* / pathology
Rhinitis* / physiopathology
Sinusitis* / drug therapy
Sinusitis* / pathology
Sinusitis* / physiopathology
Treatment Failure
Treatment Outcome