Mometasone furoate gel: a novel in-office treatment of recalcitrant postoperative chronic rhinosinusitis.

Abstract

To assess the effect of in-office intranasal application of mometasone furoate (MF) gel in reducing sinonasal mucosal inflammation in patients who have undergone endoscopic sinus surgery (ESS) for chronic rhinosinusitis. Retrospective review. Symptomatic post-ESS patients were evaluated with nasal endoscopy. Sinus mucosa was graded as normal, edematous, polypoid, or with frank polyps (scored as 0, 1, 2, or 3, respectively), and the presence or absence of eosinophilic mucin was noted. MF gel was then applied under endoscopic visualization to sinus mucosa demonstrating signs of inflammation. Patients returned to the clinic for three follow-up visits for nasal endoscopy and mucosal evaluation and, if indicated, retreatment with MF gel. Sixteen patients were treated with hydrophilic MF gel. The volume and concentrations applied were 2 to 10 cc of 1200 μg/5 cc MF gel (ASL Pharmacy, Camarillo, CA). At the initial visit, the average mucosal score was 2.19 ± 0.16. At follow-up visits 1 and 2, the average mucosal score was 1.44 ± 0.25 (p = .01) and 1.38 ± 0.28 (p = .03), respectively. There was an observed overall decrease in systemic steroid use. In-office endoscopic sinonasal application of MF gel is a useful adjunct to treat mucosal inflammation in postoperative patients with chronic rhinosinusitis. It may help reduce the need for systemic as well as topical steroid therapy.