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Latest developments on topical therapies in chronic rhinosinusitis
Neil C W Tan1,2, Alkis J Psaltis3
1Department of Otolaryngology, Royal Cornwall Hospital, Truro.
Current Opinion in Otolaryngology & Head and Neck Surgery
|December 3, 2019
Summary
Topical steroids with saline nasal rinses are the best treatment for chronic rhinosinusitis (CRS). Novel therapies show promise but require more research before clinical use.
Area of Science:
- Otolaryngology
- Rhinology
- Medical Research
Background:
- Chronic rhinosinusitis (CRS) management relies heavily on topical therapies.
- Recalcitrant CRS cases require evaluation of current and novel treatment options.
Purpose of the Study:
- To review recent evidence on topical therapies for chronic rhinosinusitis (CRS).
- To assess novel treatments for recalcitrant CRS.
Main Methods:
- Detailed literature review.
- Appraisal of current and emerging topical treatments for CRS.
Main Results:
- Budesonide nasal rinses with saline irrigation improve CRS symptoms and are safe.
- Topical steroids may have antibacterial properties.
- Topical antibiotics are not routinely recommended but may aid short-term eradication.
- Novel treatments like bacteriophage, colloidal silver, and manuka honey lack robust evidence for routine use.
Conclusions:
- Topical steroids combined with saline nasal irrigation are a standard of care for CRS.
- Surgical interventions enhance topical steroid delivery and improve long-term outcomes.
- Novel treatments for CRS are currently limited to research settings.
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