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Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods.

Sophia C Poletti1, Islam Batashev1, Jens Reden1

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Summary

Topical steroid therapy significantly improves smell in chronic rhinosinusitis (CRS) patients. However, neither a conventional nasal spray nor a specialized device showed superiority in enhancing olfaction.

Keywords:
Conventional nasal sprayNasal cavityNoseOlfactory mucosaPressure-pulsed nasal inhalationSinusitisTherapy

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Olfactory Dysfunction

Background:

  • Topical steroid therapy is a common treatment for chronic rhinosinusitis (CRS).
  • Limited olfactory improvement in CRS patients may stem from inadequate drug delivery to the olfactory cleft.
  • Investigating novel drug delivery methods is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To compare the efficacy of two topical steroid administration methods for improving olfaction in CRS patients.
  • To assess whether a specialized device improves steroid delivery to the olfactory cleft compared to conventional nasal spray.
  • To evaluate the impact of topical dexamethasone on olfactory function in CRS.

Main Methods:

  • A prospective study involving CRS patients with olfactory impairment.
  • Group 1: Conventional dexamethasone nasal spray.
  • Group 2: Dexamethasone administered via a pressure and vibration device for 12 days; olfactory testing at baseline, 2 weeks, and 8 weeks using the Sniffin' Sticks test.

Main Results:

  • Significant olfactory improvement was observed in both treatment groups after 2 weeks (p = 0.005).
  • No statistically significant difference in olfactory improvement was found between the conventional nasal spray and the specialized device.
  • Topical dexamethasone therapy demonstrated efficacy in improving olfaction for CRS patients.

Conclusions:

  • Topical dexamethasone therapy provides significant olfactory improvement for patients with chronic rhinosinusitis.
  • Current evidence does not support the superiority of a specialized pressure and vibration device over conventional nasal spray for steroid delivery to the olfactory cleft.
  • Further research may be needed to optimize drug delivery systems for enhanced olfactory outcomes in CRS.