Corticosteroid Treatment in Chronic Rhinosinusitis: The Possibilities and the Limits

Mullol, Joaquim; Obando, Andr es; Pujols, Laura; Alobid, Isam

doi:10.1016/j.iac.2009.07.001

Cited by 100 publications

(88 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(31)(32)(33)(34)(35) Following sinus surgery, topical nasal drug medication is often prescribed to prevent recurrent disease. (36) In the absence of pathological abnormalities, anthropologists believed that variations in normal nasal shapes and sizes of the external nose were due to evolutionary adaptation of humans to climatic conditions. (37,38) Specifically, the ratio between the width and height of the external nose, known as the ''nasal index'' has been reported to correlate with geographic regions: (39) the ''platyrrhine'' (broad-nose) nasal index, described as a typical nose of the African race is associated with a hot, moist climate; a typical Caucasian nose, classified as ''leptorrhine'' (narrow-nose) nasal index is associated with a cold, dry climate; and a classic Asian nose is considered medium sized and is classified as ''mesorrhine''.…”

Section: Introductionmentioning

confidence: 99%

A Computational Study of Nasal Spray Deposition Pattern in Four Ethnic Groups

Keeler

Patki

Woodard

et al. 2016

Journal of Aerosol Medicine and Pulmonary Drug Delivery

View full text Add to dashboard Cite

Background: Very little is known about the role of nasal morphology due to ethnic variation on particle deposition pattern in the sinonasal cavity. This preliminary study utilizes computational fluid dynamics (CFD) modeling to investigate sinonasal airway morphology and deposition patterns of intranasal sprayed particles in the nose and sinuses of individuals from four different ethnic groups: African American (Black); Asian; Caucasian; and Latin American. Methods: Sixteen subjects (four from each ethnic group) with ''normal'' sinus protocol computed tomography (CT) were selected for CFD analysis. Three-dimensional reconstruction of each subject's sinonasal cavity was created from their personal CT images. CFD simulations were carried out in ANSYS Fluent TM in two phases: airflow phase was done by numerically solving the Navier-Stokes equations for steady state laminar inhalation; and particle dispersed phase was solved by tracking injected (sprayed) particles through the calculated airflow field. A total of 10,000 particle streams were released from each nostril, 1000 particles per diameter ranging from 5 lm to 50 lm, with size increments of 5 lm. Results: As reported in the literature, Caucasians (5.31 -0.42 cm

show abstract

Section: Introductionmentioning

confidence: 99%

A Computational Study of Nasal Spray Deposition Pattern in Four Ethnic Groups

Keeler

Patki

Woodard

et al. 2016

Journal of Aerosol Medicine and Pulmonary Drug Delivery

View full text Add to dashboard Cite

show abstract

“…Compared with a placebo, corticosteroids have improved overall symptom scores, reduced polyp sizes, decreased polyp scores, and prevented polyp recurrence after sinus surgery. 15,16 Nevertheless, even with corticosteroid therapy and surgical intervention, more than 10% of severe CRSwNP patients show corticosteroid resistance. 17 There has been much research into the immunologic basis of CRSwNP with the aim of identifying more targeted pharmacologic therapies.…”

Section: Discussionmentioning

confidence: 99%

Expression of cysteinyl leukotriene receptor GPR17 in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps

Chen

Yang

et al. 2017

Asian Pac J Allergy Immunol

View full text Add to dashboard Cite

Background: The cysteinyl leukotrienes (cysLTs) are proinflammatory lipid mediators that act on the type 1 cysLT receptor (CysLT1R) in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). GPR17, a G protein-coupled orphan receptor with homology to the cysLT receptors, has been proposed as a damage sensor during inflammation. However, the expression and correlation of GPR17 and CysLT1R in eosinophilic CRSwNP (ECRS) and non-eosinophilic CRSwNP (non-ECRS) have not been well investigated.

show abstract

“…Random sequence generation (1) Allocation concealment (1) Blinding of participants and personnel (2) Blinding of outcome assessment (3) Incomplete outcome data objective outcomes (4) Incomplete outcome data subjective outcomes (4) Selective reporting (5) Other bias Comment…”

Section: Studymentioning

confidence: 99%

“…Treatment with oral glucocorticoids is common for patients with nasal polyps (NP, also named chronic rhinosinusitis with polyps, CRSwNP) with or without asthma (1) . A commonly suggested regimen for adults is 0.5-1.0 mg/kg of prednisolone or prednisolone equivalent daily for 5-14 days, in combination with a topical nasal steroid (1,2) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The risk of osteoporosis in oral steroid treatment for nasal polyposis: a systematic review

Winblad¹,

Larsen²,

Håkansson³

et al. 2017

Rhin

View full text Add to dashboard Cite

Background: Systemic glucocorticoids are often used in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), and osteoporosis is a well-known complication to steroid treatment, associated with significant morbidity. Nevertheless, the burden of steroid induced osteoporosis is unknown in patients with CRSwNP. We aimed to assess the risk of acquiring osteoporosis caused by oral steroids in patients with CRSwNP, and provide recommendations on future research and guidelines.Methodology: Cochrane Review Database, EMBASE, Ovid Medline, and PubMed were searched for studies including adult patients with CRSwNP treated with oral steroids. Outcomes were Bone Mineral Density (BMD) and prevalence of fractures in relation to dose and duration of oral steroids. In addition, we reviewed general guidelines for treatment with oral steroids. Results:We identified two studies (n=243) that met the inclusion criteria. Doses and durations of oral steroids were >5 mg/day for ≥3 months and 1 mg/kg body weight/day for 6 to 10 days for ≥4 courses/year. The prevalence of low bone mass was 39% and 61%, respectively. It was not possible to quantify the overall risk of osteoporosis induced by oral steroids from the studies. No studies evaluated prevalence of fracture. Conclusions:Registry studies and randomized controlled trials would be needed to assess the risk of osteoporosis in CRSwNP patients and future guidelines should include recommendations regarding preventive treatment and recommendations on doses and durations of oral steroids.

show abstract

Corticosteroid Treatment in Chronic Rhinosinusitis: The Possibilities and the Limits

Cited by 100 publications

References 64 publications

A Computational Study of Nasal Spray Deposition Pattern in Four Ethnic Groups

A Computational Study of Nasal Spray Deposition Pattern in Four Ethnic Groups

Expression of cysteinyl leukotriene receptor GPR17 in eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps

The risk of osteoporosis in oral steroid treatment for nasal polyposis: a systematic review

Contact Info

Product

Resources

About