Improved sinonasal symptom and endoscopy sinus scores with dose‐escalated intranasal mometasone irrigation in patients with refractory chronic rhinosinusitis

Papagiannopoulos, Peter; Brown, Hannah J.; Kim, Young Jae; Houser, Thomas K.; Ganti, Ashwin; Raad, Richard A; Kuan, Edward C.; LoSavio, Phillip; Batra, Pete S.; Tajudeen, Bobby A.

doi:10.1002/alr.22940

Cited by 1 publication

(1 citation statement)

References 9 publications

(17 reference statements)

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“…Papagiannopoulos et al studied dose-escalated intranasal mometasone irrigations after ESS and found a significant decrease in LK score in high dose (2 mg twice daily) compared to low dose (1 mg twice daily) treatment, with SNOT-22 scores being similarly decreased between groups. 16 A double-blinded RCT compared mometasone irrigation (2 mg daily) to mometasone spray (2 mg daily) for 12 months post-ESS and concluded that the irrigation group had more robust improvement in nasal obstruction, Lund-Mackay (LMK) scores, modified Lund-Kennedy (mLK) scores, and subjective Visual Analog Scale (VAS) compared to the spray group. 17 Budesonide.…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

State of the Art Medical Management of Nasal Polyps

Staricha

Ali

Stokken

2023

Am J Rhinol�Allergy

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Background Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory disease with a treatment goal of controlling symptoms and limiting disease burden. While endoscopic sinus surgery is effective for removing polyps and aerating sinuses, proper medical management remains necessary for reducing inflammation and limiting polyp recurrence. Objective This article aims to summarize the literature regarding medical treatment of chronic rhinosinusitis with nasal polyposis, with a specific focus on developments in the past 5 years. Methodology We conducted a literature review using PubMed to identify studies assessing medical treatment strategies for patients with CRSwNP. Articles focusing on chronic rhinosinusitis without nasal polyposis were excluded unless specifically stated. Surgical treatment and biologic therapies for CRSwNP will be covered in subsequent chapters and are therefore not included. Results Intranasal saline irrigations and topical steroids are mainstays of CRSwNP treatment in the pre-surgical, post-surgical, and maintenance phases of the disease. Alternative steroid delivery methods and adjunctive treatments with antibiotics, anti-leukotrienes, and other topical therapies have been investigated and may benefit certain patient populations, but convincing evidence does not exist to warrant addition of these treatments to the standard of care for CRSwNP. Conclusions Topical steroid therapy is clearly effective for CRSwNP, and recent studies demonstrate the safety and efficacy of high-dose nasal steroid rinses. Alternate delivery methods for local steroids may be useful for patients who are not responding to or who are noncompliant with conventional intranasal corticosteroid sprays and rinses. Future studies are needed to clarify if oral or topical antibiotics, oral anti-leukotrienes, or other novel therapies are significantly effective in decreasing symptoms and improving the quality of life in patients with CRSwNP.

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Section: Topical Corticosteroidsmentioning

confidence: 99%