Abstract
Chronic rhinosinusitis (CRS) is a common inflammatory disease of the paranasal sinuses associated with severe impairments in patient quality of life, sleep, and productivity. Topical corticosteroid therapy is a key component to a successful management plan for patients with CRS. Delivering topical medical therapies using high-volume sinonasal irrigations are commonly used following endoscopic sinus surgery (ESS) due to its proven efficacy for improving drug delivery into the paranasal sinuses. Topical high volume budesonide irrigations have become a popular offlabel management strategy for CRS with the purpose to improve topical steroid delivery into the sinonasal cavities. Early evidence outlined in this review suggests that high volume sinonasal budesonide irrigations are an effective treatment modality in patients with CRS following ESS. Overall it appears that short-term use of this therapy is likely safe, however, future studies will need to assess the safety of higher doses and longer-term therapy of budesonide irrigations in patients with CRS.
Highlights
Chronic rhinosinusitis (CRS), otherwise known as chronic sinusitis, is a common inflammatory disease of the paranasal sinuses affecting approximately 7% to 14% of the North American population [1,2]
All groups received significant postoperative outcome improvements in disease-specific quality of life (QoL) and endoscopy, there was no difference in outcomes between groups
This study demonstrated no positive clinical effect of budesonide irrigations, it is important to interpret the findings in the context of CRS patients with Samter’s triad
Summary
Chronic rhinosinusitis (CRS), otherwise known as chronic sinusitis, is a common inflammatory disease of the paranasal sinuses affecting approximately 7% to 14% of the North American population [1,2]. Patients with CRS suffer from several detrimental health effects including reduced quality of life (QoL) [3], impaired sleep [4], fatigue [5], acute infections [6], and increased bodily pain [7]. One of the biggest challenges with topical sinonasal medical therapy is the efficiency of delivery into the sinuses in order to adequately treat the underlying mucosal inflammation, especially in the setting of obstructing un-dissected sinus lamellae and potentially obstructing polyps. Attempts to overcome this inherent challenge have resulted in the development of several different delivery techniques.
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