Topical corticosteroid irrigations in chronic rhinosinusitis

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Pharmacology

Background:

• Chronic rhinosinusitis (CRS) is increasingly recognized as a primary inflammatory airway disease, distinct from infectious or obstructive causes.
• Effective management of CRS requires addressing diffuse airway inflammation, similar to asthma.
• Topical corticosteroid therapy is a key component in managing CRS inflammation.

Purpose of the Study:

• To evaluate the efficacy and safety of topical corticosteroid irrigations for chronic rhinosinusitis.
• To assess the role of corticosteroid irrigations in the context of primary CRS management.

Main Methods:

• A focused literature review was performed, identifying 11 original articles published between 2013 and 2018.
• Studies included in the review evaluated the safety and efficacy of topical corticosteroid irrigations.

Main Results:

• Evidence suggests potential benefits of corticosteroid irrigations over sprays or saline in specific studies.
• Some studies indicated improved outcomes in certain patient populations with corticosteroid irrigations.
• Five studies found no significant increase in adverse side effects associated with topical corticosteroid use.

Conclusions:

• Accurate diagnosis of inflammatory CRS is crucial for effective treatment.
• Endoscopic sinus surgery facilitates adequate topical therapy delivery.
• Topical corticosteroid irrigations are safe for long-term daily use and represent a valuable first-line treatment for postsurgical CRS.