Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 3/2017

11.10.2016 | Rhinology

Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods

verfasst von: Sophia C. Poletti, Islam Batashev, Jens Reden, Thomas Hummel

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Limited olfactory improvement after topical steroid therapy in chronic rhinosinusitis (CRS) patients might result from restricted drug access to the olfactory cleft. The aim of our study was to investigate the difference between two methods to topically administer steroids with respect to olfaction: (1) conventional nasal spray and (2) a device using pressure and vibration to distribute steroid aerosol endonasally. A prospective study was performed in patients with olfactory impairment due to chronic rhinosinusitis with and without nasal polyps. While the first group used the conventional dexamethasone nasal spray, the second group used the device over a period of 12 days. Olfactory testing was done at 0, 2, and 8 weeks using Sniffin’ Sticks test. A significant olfactory improvement was found after 2 weeks of treatment with either steroid (p = 0.005). However, there was no significant difference between the different methods of steroid application. There is a significant olfactory improvement in CRS patients following topical dexamethasone therapy, but no obvious superiority of one of the two ways to administer the steroid.
Literatur
1.
Zurück zum Zitat Litvack JR, Fong K, Mace J, James KE, Smith TL (2009) NIH Public Access 118(12):2225–2230 Litvack JR, Fong K, Mace J, James KE, Smith TL (2009) NIH Public Access 118(12):2225–2230
2.
Zurück zum Zitat Jiang RS, Lu FJ, Liang KL et al (2008) Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery. Am J Rhinol 4:445–448CrossRef Jiang RS, Lu FJ, Liang KL et al (2008) Olfactory function in patients with chronic rhinosinusitis before and after functional endoscopic sinus surgery. Am J Rhinol 4:445–448CrossRef
3.
Zurück zum Zitat Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 23:1–298 Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 23:1–298
4.
Zurück zum Zitat Heilmann S, Huettenbrink K-B, Hummel T (2004) Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol 18(1):29–33PubMed Heilmann S, Huettenbrink K-B, Hummel T (2004) Local and systemic administration of corticosteroids in the treatment of olfactory loss. Am J Rhinol 18(1):29–33PubMed
5.
Zurück zum Zitat Alobid I, Benítez P, Cardelús S et al (2014) Oral plus nasal corticosteroids improve smell, nasal congestion, and inflammation in sino-nasal polyposis. Laryngoscope 124(1):50–56CrossRefPubMed Alobid I, Benítez P, Cardelús S et al (2014) Oral plus nasal corticosteroids improve smell, nasal congestion, and inflammation in sino-nasal polyposis. Laryngoscope 124(1):50–56CrossRefPubMed
6.
Zurück zum Zitat Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B (2011) Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med 154(5):293–302CrossRefPubMed Vaidyanathan S, Barnes M, Williamson P, Hopkinson P, Donnan PT, Lipworth B (2011) Treatment of chronic rhinosinusitis with nasal polyposis with oral steroids followed by topical steroids: a randomized trial. Ann Intern Med 154(5):293–302CrossRefPubMed
7.
Zurück zum Zitat Keith P, Nieminen J, Hollingworth K, Dolovich J (2000) Efficacy and tolerability of fluticasone propionate nasal drops 400 mcg daily compared with placebo for the treatment of bilateral polyposis in adults. Clin Exp Allergy 30(10):1460–1468CrossRefPubMed Keith P, Nieminen J, Hollingworth K, Dolovich J (2000) Efficacy and tolerability of fluticasone propionate nasal drops 400 mcg daily compared with placebo for the treatment of bilateral polyposis in adults. Clin Exp Allergy 30(10):1460–1468CrossRefPubMed
8.
Zurück zum Zitat Friedman M, Hamilton C, Samuelson CG et al (2012) Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study. Int Forum Allergy Rhinol 2(3):252–257CrossRefPubMed Friedman M, Hamilton C, Samuelson CG et al (2012) Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study. Int Forum Allergy Rhinol 2(3):252–257CrossRefPubMed
9.
Zurück zum Zitat Leopold DA, Hummel T, Schwob JE, Hong SC, Knecht M, Kobal G (2000) Anterior distribution of human olfactory epithelium. Laryngoscope 110(3 Pt 1):417–421CrossRefPubMed Leopold DA, Hummel T, Schwob JE, Hong SC, Knecht M, Kobal G (2000) Anterior distribution of human olfactory epithelium. Laryngoscope 110(3 Pt 1):417–421CrossRefPubMed
10.
Zurück zum Zitat Dilisio MF (2014) Osteonecrosis following short-term, low-dose oral corticosteroids: a population-based study of 24 million patients. Orthopedics 37(7):e631–e636CrossRefPubMed Dilisio MF (2014) Osteonecrosis following short-term, low-dose oral corticosteroids: a population-based study of 24 million patients. Orthopedics 37(7):e631–e636CrossRefPubMed
11.
Zurück zum Zitat Mori E, Merkonidis C, Cuevas M, Gudziol V, Matsuwaki Y, Hummel T (2015) The administration of nasal drops in the “Kaiteki” position allows for delivery of the drug to the olfactory cleft: a pilot study in healthy subjects. Eur Arch Oto-Rhino-Laryngol 273(4):1–5 Mori E, Merkonidis C, Cuevas M, Gudziol V, Matsuwaki Y, Hummel T (2015) The administration of nasal drops in the “Kaiteki” position allows for delivery of the drug to the olfactory cleft: a pilot study in healthy subjects. Eur Arch Oto-Rhino-Laryngol 273(4):1–5
12.
Zurück zum Zitat Scheibe M, Bethge C, Witt M, Hummel T, Article O (2008) Intranasal administration of drugs. Arch Otolaryngol Head Neck Surg 134(6):643–646CrossRefPubMed Scheibe M, Bethge C, Witt M, Hummel T, Article O (2008) Intranasal administration of drugs. Arch Otolaryngol Head Neck Surg 134(6):643–646CrossRefPubMed
13.
Zurück zum Zitat Kayarkar R, Clifton NJ, Woolford TJ (2002) An evaluation of the best head position for instillation of steroid nose drops. Clin Otolaryngol Allied Sci 27(1):18–21CrossRefPubMed Kayarkar R, Clifton NJ, Woolford TJ (2002) An evaluation of the best head position for instillation of steroid nose drops. Clin Otolaryngol Allied Sci 27(1):18–21CrossRefPubMed
15.
Zurück zum Zitat Goektas O, Lau L, Olze H (2013) Treatment of chronic rhinosinusitis with pressure-pulsed corticosteroid inhalation. Indian J Otolaryngol Head Neck Surg. 65(SUPPL2):402–405CrossRefPubMedPubMedCentral Goektas O, Lau L, Olze H (2013) Treatment of chronic rhinosinusitis with pressure-pulsed corticosteroid inhalation. Indian J Otolaryngol Head Neck Surg. 65(SUPPL2):402–405CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) “Sniffin” sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52CrossRefPubMed Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) “Sniffin” sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52CrossRefPubMed
17.
Zurück zum Zitat Kobal G, Klimek L, Wolfensberger M et al (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 257(4):205–211CrossRefPubMed Kobal G, Klimek L, Wolfensberger M et al (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol 257(4):205–211CrossRefPubMed
18.
Zurück zum Zitat Penttilä M, Poulsen P, Hollingworth K, Holmström M (2000) Dose-related efficacy and tolerability of fluticasone propionate nasal drops 400 microg once daily and twice daily in the treatment of bilateral nasal polyposis: a placebo-controlled randomized study in adult patients. Clin Exp Allergy 30(1):94–102CrossRefPubMed Penttilä M, Poulsen P, Hollingworth K, Holmström M (2000) Dose-related efficacy and tolerability of fluticasone propionate nasal drops 400 microg once daily and twice daily in the treatment of bilateral nasal polyposis: a placebo-controlled randomized study in adult patients. Clin Exp Allergy 30(1):94–102CrossRefPubMed
19.
Zurück zum Zitat Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Laryngoscope 116(10):1858–1863CrossRefPubMed Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Laryngoscope 116(10):1858–1863CrossRefPubMed
20.
Zurück zum Zitat Reychler G, Colbrant C, Huart C et al (2015) Effect of three-drug delivery modalities on olfactory function in chronic sinusitis. Laryngoscope 125(3):549–555CrossRefPubMed Reychler G, Colbrant C, Huart C et al (2015) Effect of three-drug delivery modalities on olfactory function in chronic sinusitis. Laryngoscope 125(3):549–555CrossRefPubMed
21.
Zurück zum Zitat Doty RL, Mishra A (2001) Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope 111(3):409–423CrossRefPubMed Doty RL, Mishra A (2001) Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope 111(3):409–423CrossRefPubMed
22.
Zurück zum Zitat Klimek L, Eggers G (1997) Olfactory dysfunction in allergic rhinitis is related to nasal eosinophilic inflammation. J Allergy Clin Immunol 100(2):158–164CrossRefPubMed Klimek L, Eggers G (1997) Olfactory dysfunction in allergic rhinitis is related to nasal eosinophilic inflammation. J Allergy Clin Immunol 100(2):158–164CrossRefPubMed
23.
Zurück zum Zitat Weber R, Keerl R, Radziwill R et al (1999) Videoendoscopic analysis of nasal steroid distribution. Rhinology 37(2):69–73PubMed Weber R, Keerl R, Radziwill R et al (1999) Videoendoscopic analysis of nasal steroid distribution. Rhinology 37(2):69–73PubMed
24.
Zurück zum Zitat Bateman ND, Whymark AD, Clifton NJ, Woolford TJ (2002) A study of intranasal distribution of azelastine hydrochloride aqueous nasal spray with different spray techniques. Clin Otolaryngol Allied Sci 27(5):327–330CrossRefPubMed Bateman ND, Whymark AD, Clifton NJ, Woolford TJ (2002) A study of intranasal distribution of azelastine hydrochloride aqueous nasal spray with different spray techniques. Clin Otolaryngol Allied Sci 27(5):327–330CrossRefPubMed
25.
Zurück zum Zitat Fowler PD, Gazis AG, Page SR, Jones NS (2002) A randomized double-blind study to compare the effects of nasal fluticasone and betamethasone on the hypothalamo-pituitary-adrenal axis and bone turnover in patients with nasal polyposis. Clin Otolaryngol Allied Sci 27(6):489–493CrossRefPubMed Fowler PD, Gazis AG, Page SR, Jones NS (2002) A randomized double-blind study to compare the effects of nasal fluticasone and betamethasone on the hypothalamo-pituitary-adrenal axis and bone turnover in patients with nasal polyposis. Clin Otolaryngol Allied Sci 27(6):489–493CrossRefPubMed
26.
Zurück zum Zitat Croy I, Nordin S, Hummel T (2014) Olfactory disorders and quality of life-an updated review. Chem Senses 39(3):185–194CrossRefPubMed Croy I, Nordin S, Hummel T (2014) Olfactory disorders and quality of life-an updated review. Chem Senses 39(3):185–194CrossRefPubMed
27.
Zurück zum Zitat Fardet L, Kassar A, Cabane J, Flahault A (2007) Corticosteroid-induced adverse events in adults: frequency, screening and prevention. Drug Saf 30(10):861–881CrossRefPubMed Fardet L, Kassar A, Cabane J, Flahault A (2007) Corticosteroid-induced adverse events in adults: frequency, screening and prevention. Drug Saf 30(10):861–881CrossRefPubMed
Metadaten
Titel
Olfaction in chronic rhinosinusitis: comparing two different endonasal steroid application methods
verfasst von
Sophia C. Poletti
Islam Batashev
Jens Reden
Thomas Hummel
Publikationsdatum
11.10.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 3/2017
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-016-4341-6

Weitere Artikel der Ausgabe 3/2017

European Archives of Oto-Rhino-Laryngology 3/2017 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.