The Use of Topical and Systemic Steroids in the Treatment of Nasal Disorders

Abstract

At the April meeting of the American Rhinologic Society, Palm Beach, Fla, Murray Sacks, MD, Rochester, Minn, presented his work on the use of topical and systemic steroids in the treatment of nasal disorders. Sacks classified rhinitis into three types: allergic, nonallergic with eosinophilia, and nonallergic without eosinophilia (vasomotor rhinitis). Earlier double-blind cross-over studies from The Johns Hopkins University, Baltimore, demonstrated the efficacy of both topical beclomethasone and flunisolide in the treatment of allergic rhinitis. The prolonged use of topical nasal steroid therapy appears to be safe. The primary local complication is burning, a problem more frequent with flunisolide. Other local complications, such as epistaxis, may be seen occasionally, but other complications are rare when the medications are used at the recommended doses. Systemic effects have not been observed. A previous study of nonallergic rhinitis with eosinophilia demonstrated that 52% of these patients have sinusitis and 33% have nasal polyps.